do anesthesiologists do?
Anesthesiologists are concerned with many aspects of a child's
care. Their main task is to provide safe, optimal conditions
during surgery and to make the entire hospital stay as pleasant
and comfortable as possible.
Anesthesiologists consider any surgical procedure performed
on your child to be of major importance. They are constantly
on guard for changes in breathing, heart action, blood pressure
or unexpected events which, although rare, may occur during
surgery. Apart from assuring the optimal safety of your
child during surgery, anesthesiologists are specially trained
in how to make the operative procedure as comfortable as
possible for your child. Anesthesiologists know how children
react to hospitals and surgery. As physicians, they work
with other doctors such as pediatricians, surgeons and other
specialists to improve the quality of your child's entire
You also may meet anesthesiologists in other hospital areas.
For example, if your child needs a specialized radiological
test including diagnostic scans, an anesthesiologist may
well be present to provide anesthesia or safe sedation for
your child. Following surgery, anesthesiologists are often
involved in providing pain relief for your child and are
consulted in the pediatric intensive care unit. Even if
your child is not undergoing an operation, an anesthesiologist
may be consulted for pain management, respiratory care and
other medical situations.
can I as a parent help?
The anesthesiologist and the surgeon will do their best
to make your child's visit to the hospital as pleasant as
possible; however, you also have a key role to play in your
child's care. It is important that you begin preparing your
child for the operation as soon as a decision is made to
perform surgery. Children tolerate surgery and anesthesia
better when they are well-prepared. As with all of us, children
have natural fears of the unknown. Anything you can do to
relieve these anxieties and to inform your child about the
coming events in the hospital and the operating room will
greatly improve your child's experience.
Before you explain to your child what to expect, you also
must learn what to expect. It is very important to learn
about your child's anesthetic experience beforehand by discussing
it with the anesthesiologist in the preanesthetic interview.
Once you learn what will happen, you will gain confidence
and be better able to talk calmly and honestly to your child.
Honesty is a key word. Your child should be told that he
or she will be in unfamiliar surroundings but will meet
many friendly doctors and nurses. Children need to know
that they will have an operation and that there may be some
discomfort afterward. Let them know that you may not be
with them every minute but will be waiting nearby.
Your composure as a parent is essential. Nothing calms a
child more than a confident parent. Although it is natural
for parents to have anxiety when their children are having
surgery, it is best not to convey this to your child. Talk
to your child about what to expect in the hospital such
as corridors, hospital beds and the presence of other children.
Reassure your child that everything done during the hospital
stay will be explained beforehand.
will the anesthesiologist need to know?
The anesthesiologist will want to make sure that your child
is in the best possible physical condition before surgery.
You will be asked important questions about your child's
general health, including whether he or she has allergies
or asthma, whether there has been any family history of
difficulties with anesthesia and what your child's experiences
have been with previous anesthetics. During this evaluation,
the anesthesiologist will explain the planned anesthetic
procedures. The discussion may include whether or not your
child will receive anything for sedation before surgery,
how the anesthetic will be initiated and maintained, and
other pertinent anesthetic details. This is the best time
for you and your child to ask questions and express any
concerns to the anesthesiologist.
Sometimes minor illnesses such as sniffles and colds may
cause problems during some types of surgery and anesthesia.
For this reason, the anesthesiologist may feel it is best
to postpone surgery. Remember, the anesthesiologist has
your child's safety in mind.
if my child has outpatient surgery?
Outpatient surgery for certain operations has become very
common and can be performed without a hospital admission.
This means that information about your child needed by the
anesthesiologist will be obtained the day of surgery or
at some meeting arranged before the day of surgery. Although
outpatient or same-day surgery is usually performed for
"small" operations, the anesthesia is never "small."
It is just as important to follow preoperative directions
for outpatient surgery as for operations when your child
is brought into the hospital overnight. For example, it
is very important for your child's safety to follow closely
the anesthesiologist's instructions concerning food and
my child receive any medication before surgery?
In the past, virtually every child received an injected
sedative before being taken to the operating room. We now
realize that many children need less sedation when calm,
assured and confident parents help them through the stress
of a procedure or hospitalization. In spite of parents'
reassurances, however, some children still may require medicine
to calm them before surgery. This medication may be given
by mouth, injection or rectal suppository. The time before
surgery that such premedication is given will vary. The
type of medicine used, if any, will be determined by the
anesthesiologist during the preoperative visit.
will my child be given anesthesia?
Anesthetic agents can be started in several ways. Most commonly
in adults, anesthesia is started by an intravenous injection
so the patient becomes unconscious rapidly. This is also
a method that can be used for children. Another method of
beginning anesthesia is to let your child breathe anesthetic
agents until losing consciousness. This is called a mask
or inhalational induction. With this approach, your child
will be asked to breathe through a "space mask"
quietly, and no needlesticks will be performed until after
your child is sound asleep. The choice of which method to
begin anesthesia will be made by the anesthesiologist based
on many factors.
Although anesthetics can provide complete pain relief and
loss of consciousness during an operation, they do occasionally
have side effects. They tend to decrease breathing, heart
action and blood pressure. The anesthesiologist is specially
trained to ensure that these anesthetic effects are minimized.
Different children may awaken from anesthesia at differing
rates. Some children may be fully alert upon arriving in
the recovery room. Others may be groggy for hours after
surgery. If you have any concerns about your child's recovery,
you should feel free to ask your anesthesiologist. Although
operations are much safer these days, they still produce
stress on the body and may cause your child to have a "sick"
feeling. Nausea and vomiting are occasional side effects
after surgery and anesthesia.
about regional anesthesia for my child?
In recent years, it has become possible to provide pain
relief to specific areas of the body rather than give general
anesthesia that causes unconsciousness. For example, if
your child is having foot surgery, it is possible to eliminate
the feeling of pain in only the foot, either with a local
injection of an anesthetic or by regional anesthesia. The
most common type of regional anesthesia used in children
is called epidural anesthesia. This is very similar to the
anesthesia used for childbirth when local anesthesia is
injected into the back or tailbone region. Intravenous sedation
or inhaled anesthetic agents may be combined with a regional
anesthetic. This combination may allow the anesthesiologist
to give less general anesthesia. Another advantage is that
regional anesthesia is often used to provide pain relief
after surgery. Your anesthesiologist can discuss the advantages
and disadvantages of regional anesthesia with you.
is pain controlled after surgery?
The anesthesiologist may be consulted to help manage your
child's pain following the surgery. Although "painkilling"
injections are still commonly used, other forms of pain
management may also be chosen to provide comfort. For instance,
patient-controlled analgesia (PCA) allows a child to self-administer
a controlled dose of pain-relieving medicine when needed.
A small, computerized pump is programmed by the anesthesiologist,
and children 8 years old or older may be instructed on PCA
Another approach is the insertion of a tiny epidural catheter
in your child's back through which a small dose of medication
for pain relief can be given. This allows the child to be
more awake and lessens the chance for complications from
the use of other pain medications. Sometimes, the epidural
pain relief can be continued for several days after the
Will I be charged for the anesthesia
anesthesiologist is a consulting physician who evaluates
your child before the operation. ensures a safe, individualized
anesthetic during the entire surgery and provides pain relief
following the operation. Like other medical specialists,
the anesthesiologist will charge for professional services,
and this fee will be separate from the surgeon's fee or
hospital's charges. The anesthesiologist's fee reflects
the high level of professional care that the anesthesiologist
provides for your child during his or her hospital visit.