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Anesthesia Associates of Southern Connecticut

Pediatric Anesthesia in the Operating Room

Please read the Pediatric FAQ section for detailed answers to many of your questions.

Safety is the highest priority for the anesthesiologist in pediatric surgery. However, we recognize that this is an extremely stressful time for the child and for the parents, and we strive to reduce the stress as much as possible.

There are different approaches to the care of children in the Operating Room. At Norwalk Hospital, we allow parents to be with the child every moment he or she is awake. We have found that, in most cases, this eliminates the need for preoperative sedation, which allows for a quicker recovery, especially in short cases. In children who are extremely anxious, a sedative can be given, usually by mouth.

PREOPERATIVE PHASE

When you and your child arrive at the ambulatory surgery area on the 5th floor, you will be either directed to the pediatric ambulatory area, or if your child is older, say an adolescent, to the adult area. You and your child will be interviewed to insure that all medical issues are known. Vital signs will be taken by the nurse. The anesthesiologist will meet you in the preoperative area and conduct a brief history and physical, and answer your questions. If the child is under age 10-12, no IV will be started in almost all cases. After age 12 or so, an IV is started.

If an IV is in place, sedation will be given through the IV.

THE TRIP TO THE OPERATING ROOM

Older children who are given sedation before going to the operating room separate easily from their parents and are wheeled to the operating room without the parents. Young children who have not had sedation are accompanied to the operating room by a parent. They may be carried, or walk, or ride on a stretcher depending on the circumstances.

Once in the operating room the child is placed on the operating table with the parent assisting and in close contact with the child.

GOING TO SLEEP

Once the child is settled on the operating table, a monitor will be placed on the finger or toe (pulse oximeter). The mask will be placed gently over the child's face, while the rest of the monitors are applied. In young children, a flavoring such as bubblegum is added to the mask to make it more pleasant. If the child accepts the mask easily, it is kept there until the child is asleep, usually less than one minute. If the child gets a little panicky and fights, he can be placed in the parent's lap and the mask applied there.
Once the child is asleep, the parent is escorted back to the waiting room. An IV is started in the sleeping child, and the procedure can begin. If this is an extremely short procedure, such as ear tubes, no IV is necessary.

RECOVERY

When the operation is over, the child is awakened in the operating room. The child is still very sleepy at this point and rarely remembers this. When the anesthesiologist is satisfied that the child is stable, she is transported to the recovery room
Once in recovery, the child is reconnected to monitors. At this point the parents are called to the recovery room to be with the child when he becomes fully awake. If the child needs any pain medicine or nausea medicine, it can be given through the IV.

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