Anesthesia is provided to children and adults so that they will not feel any discomfort during an operation or diagnostic procedure. The most common type of anesthesia is called "general anesthesia," which provides a lack of awareness, unconsciousness and varying degrees of muscle relaxation, while blocking discomfort or pain perception. In addition to general anesthesia, other techniques that may be used include "regional anesthesia"(major nerve blocks, as in spinal or epidural anesthesia) and sedation. In children regional anesthetic techniques are often used to help manage pain after surgery or painful procedures. Varying levels of sedation short of general anesthesia may be required for procedures that are not painful, such as a MRI or CT, or for painful procedures of relatively brief duration such as a lumbar puncture, bone marrow sampling or IV insertion.
Pediatric Anesthesia at Arkansas Children’s Hospital
Anesthesia at Arkansas Children’s Hospital is provided by specially trained physicians called anesthesiologists. They may be assisted in individual cases by other personnel, including anesthesia residents (physicians training to become anesthesiologists), certified registered nurse anesthetists (registered nurses who have completed additional formal education in the administration of anesthesia) and anesthesia technicians. Members of the anesthesia team are present with your child throughout the surgery or procedure. They not only administer anesthetic medicines, but also provide a variety of monitoring functions and perform such procedures as airway management, IV and arterial catheter placement and placement of regional nerve blocks and catheters.
The professional staff of the Division of Pediatric Anesthesia at ACH are members of the Department of Anesthesiology of the University of Arkansas for Medical Sciences (UAMS). Physicians and nurses in the Division of Pediatric Anesthesia provide traditional perioperative care services in the Ambulatory Surgery Center (ASC), main operating room suites, Post-anesthetic Care Unit (PACU) and many other locations throughout the hospital. These include the cardiovascular operating room/ICU complex, the gastroenterology (GI) endoscopy lab, the magnetic resonance imaging (MRI) suite and other sites on an as-needed basis. In addition, the members of the anesthesia staff provide acute and chronic pain management services on both an inpatient and outpatient basis.
The pediatric anesthesia staff is uniquely prepared to meet the physical, developmental, psychological and emotional needs of infants, children and adolescents who require anesthesia or sedation. Members of the medical staff are prepared to provide anesthesia to the tiniest premature infant, the robust high school athlete and patients of all sizes and medical conditions in between. Our anesthesiologists possess special skills and experience to develop and implement an individualized plan for inducing, maintaining, monitoring and recovering a child from anesthesia, including provisions for pain management after the procedure. A wide array of up-to-date and special equipment is available to the anesthesiologist that frequently is not available in adult hospitals.
In addition to addressing the physical needs of our child patients, their psychological needs are met throughout the anesthesia and surgery experience. We recognize that many factors will influence how children understand and react to the events of surgery, including their age, developmental status, previous experience and anxiety level. Efforts are made to prevent and reduce distress throughout the entire surgery or procedure experience
A major expansion to the surgical services area is currently under construction at ACH. This expansion will greatly enlarge the ambulatory surgery evaluation and recovery area and several new operating and procedure rooms will be added. More room and greater privacy will be available to parents and children.
The Ambulatory Surgery Center (outpatient surgery) is located on the second floor of the main hospital. The telephone number is (501) 364-1336.
You will be instructed to call the Ambulatory Surgery Center (ASC) the day before your child’s surgery to go over important information and instructions.
The information on this website does not replace the information and instructions that you will receive during that phone call or during your preoperative visit.
Arrange your own transportation to and from the hospital – you may not ride a public bus or car that is unable to make an unplanned stop when you are transporting your child home
Anticipate being at the hospital for some time: bring money for meals or bring your meals with you. Bring personal items in case your child requires an unplanned admission
Limit the number of family and friends who come to the hospital! Only two parents or caregivers are allowed in the waiting rooms and only one parent is allowed in the recovery room. While family and friends want to be supportive, too many people can cause children to become overwhelmed and also can create crowding in the areas outside the waiting rooms.
It is best not to bring your other children to the hospital. They cannot stay in the ASC or with you overnight in the hospital.
Children under 18 years of age must be with a legal guardian on the day of surgery.
Make plans for your child’s care after discharge.
If you must stay overnight before or after surgery, please tell your surgeon’s office. A list of area hotels is available.
How and when should I prepare my child for anesthesia and surgery?
Be honest with your child about where he or she is going. Do not lie to your child.
Reassure your child that he or she will be asleep during surgery and will wake up after surgery.
Reassure your child that a family member will be with him when he wakes up after surgery.
Younger children (about 8 years and under) should have things explained in terms that he will understand. For example, you might tell your four-year old that he will have an operation to "fix his tummy" or to "make his tummy better" and that he will be asleep when he has his operation. It may also help to have your younger child pick one item, such as a favorite toy, blanket or stuffed animal to bring to the hospital for security.
Older children and teenagers (about 9 years and older) should be given as much detail and information as you think they can handle. Try to encourage your child to ask questions. Help your child to think of ways to make waiting for surgery easier, such as bringing a book to read or music to listen to through headphones.
You can begin to prepare your younger child a week or so before surgery by giving information about what will happen. If your child is 3 years or under, or very anxious, you might wait until the week of surgery or just a few days before surgery to start talking about it.
Older children and teenagers can usually be prepared in advance of surgery at about the same time that you prepare. However, if he is very anxious or has a developmental delay, you might wait until the week of surgery to talk to your child in more detail.
These age ranges and guidelines are suggestions. All children are different. You know your child best and you should use your judgement about how and when to prepare your child.
This will vary by the age of your child, but in general, children cannot eat and drink after a certain time prior to their surgery. If you do not follow these fasting instructions and your child receives anesthesia, serious complications can occur, including death. It is extremely important that you follow the fasting schedule that has been discussed with you.
Your child’s safety is our primary concern!
When to stop foods and liquids prior to surgery
Child Age
Food
Formula
Water, Pedialyte, Apple Juice
0 — 6 months
Stop at midnight
Stop six hours prior to the surgery or procedure time
Stop four hours prior to surgery or procedure time
7 — 12 months
Stop at midnight
Stop eight hours prior to the surgery or procedure time
Stop four hours prior to surgery or procedure time
1 year and older
Stop at midnight
Not applicable
Stop four hours prior to surgery or procedure time
After registering, you will have a meeting with anesthesia staff to discuss your child’s current health and medical history before anesthesia can be administered. You may also ask questions and/or let staff know about any worries or concerns that you or your child have.
Waiting room
After the pre-anesthetic evaluation, you and your child will go to an area to wait for surgery.
In the waiting room, your child may be given a medicine (called "premedication" or "premed") to help him or her relax before surgery. The premedication is often given in a liquid for your child to drink, but it can also be given in other ways, such as an injection.
If your child will receive a premedication and how it will be given will depend on your child’s age (older children and teenagers may be less likely to need a premedication), medical condition and whether there is time for the medicine to work.
Going to the Operating Room
Your child may be taken to the operating room on a stretcher or be carried.
You may give your child a kiss and tell him that you will see him or her in a little while.
Although care is taken to avoid making your child upset, separation may still cause some nervousness or anxiety.
Medical staff will take good care of your child!
Anesthesia Induction
There are three major ways that your child may have anesthesia started (called "induction"):
By mask, where anesthetic gas is given that your child will breathe (usually for smaller and younger children),
By an intravenous ("IV") line, with anesthetic medicines (usually for older children) or
By an intramuscular (IM) injection, (usually used when a child will not accept the mask or IV)
Your child’s anesthesiologist will decide the best method of anesthesia induction for your child.
Recovery Room
After surgery your child will be taken to the PACU (Post Anesthetic Care Unit or the recovery room) to awaken. One parent or caregiver will be called to the PACU to be with your child, when he awakens. It is often best to have just one person remain with your child throughout the entire time in the recovery room.
Your child may be groggy or sleepy from the anesthesia. Sometimes children do not behave like their typical selves when they recover from anesthesia. For example, your child might be fussy, cranky, crying and/or difficult to comfort.
If your child will be admitted to the hospital after recovery, he will go directly to a hospital room from the PACU.
If your child is going to be discharged following surgery, he will be taken to the outpatient recovery area for about an hour before discharge. Both parents can usually visit in this other recovery area.
It is best for your child not to have a lot of family and friends at the hospital to visit your child before he or she is discharged. Your child needs to rest while recovering from anesthesia and surgery!
Your child will be discharged when he has recovered from anesthesia.
After discharge
You will receive written instructions regarding the care of your child at home.
On your child’s postoperative care instructions, there will be phone numbers listed for you to call if you have problems, questions or concerns about your child’s health.
What should I do if my child becomes sick before surgery?
If you believe your child may be catching a cold or flu or becoming ill in some other way before his surgery, please contact the ambulatory surgery center and your child’s primary care physician.
What can I do to help make my child’s surgery go smoothly and safely?
Arrive at your child’s scheduled appointment on time to avoid delays and delaying other surgeries.
Follow all instructions carefully, especially NPO instructions.
Remain flexible since emergencies or other uncontrollable factors may result in unexpected delays.
Take care of yourself! Do not fast with your child- get up earlier than he and eat a good breakfast so that you are physically ready to provide emotional support for your child.
Written educational materials are available from the Ambulatory Surgery Center. Please call (501) 364-1336 if you would like to request that either of the following pamphlets be sent to you.
Helping Your Infant, Toddler, or Young Child Before Outpatient Surgery
Helping Your Older Child or Teenager Before Outpatient Surgery.
The Bottom Line...Why You Should Choose Our Hospital
Care for children is different than care for adults. We know that at Arkansas Children's Hospital. For over 80 years, we have dedicated ourselves to bringing the latest pediatric medical expertise and technology to children of all ages. We provide services not usually found at other hospitals: pediatric-trained anesthesiologists, radiologists, nutritionists, pain managers, respiratory therapists, nurses, etc. We even have Child Life and Education staff here to explain procedures to children and to incorporate play and schoolwork into the hospital stay when appropriate. Best of all, we center our care around the family. Your team of physicians, nurses and other staff will work tirelessly to make sure your entire family has the resources it needs to better your child's health. We are dedicated to changing children's lives!
