what to expect: surgery

what to expect from the pediatric anesthesiology team when your child is having surgery

Pediatric anesthesiologists play two very important roles for children undergoing surgery at Dayton Children’s. One is to administer general anesthesia to help them sleep through the surgery. The other is to help minimize pain after surgery by using other pain relief therapies, including regional nerve blocks.

• General anesthesia Most children receive a general anesthetic to help them sleep through surgery safely. The anesthetic can be delivered using a breathing mask or intravenous tube. It produces a state of controlled unconsciousness.
• Regional nerve blocks Your child’s anesthesiologist may recommend that your child have a regional nerve block during surgery to numb part of the body. A regional nerve block takes effect during surgery, and continues to provide pain relief after surgery. Not all children receive a regional nerve block during surgery, and many of those who do also receive general anesthesia.

types of regional nerve blocks

caudal block

A caudal block numbs the lower half of the body (from the belly button down) for three to 12 hours. It is used for surgery on the lower trunk, groin or legs.

epidural nerve block

An epidural nerve block involves putting pain medicine into the space around your child’s spinal cord. The medicine is delivered through a temporary catheter (thin, flexible tube). It is used for surgery on the trunk, groin or legs.

peripheral nerve block

A peripheral nerve block involves injecting pain medication near a cluster of nerves to numb the area of the body being operated on. The anesthesiologist uses ultrasound imaging guidance to make sure the injection is given as precisely as possible.

Depending on your child’s condition, surgical procedure and pain control needs, the anesthesiologist may consider other types of pain relief strategies during surgery. These may include using a peripheral nerve catheter or a spinal anesthetic.

pre-surgery fasting guidelines

When your child is having anesthesia, it is very important that you follow the doctor’s instructions for eating and drinking beforehand. Learn more

preparing your child for anesthesia

The more you understand about what will happen before, during and after surgery with your child’s anesthesia needs, the more support and reassurance you will be able to provide.

before surgery

Before surgery, an anesthesiologist will review your child’s medical record and start making a plan. On the day of surgery, this anesthesiologist will meet with you to talk about the anesthesiology care your child will receive. If your child has complex medical needs, the conversation may take place a few days before surgery, either at the hospital or on the phone.

The type and amount of anesthesia your child receives will depend on many factors, including the type of surgery, how long it will last, medications your child is taking and your child’s age, height, weight and general health.

The anesthesiologist, surgeon or someone on the nursing staff will talk to you about what your child can eat or drink before surgery. Please follow these instructions very carefully! They are meant to keep your child safe. Learn more

Our team works closely with child life specialists at Dayton Children’s who are specially trained to help kids who are feeling anxious or scared before surgery. The child life specialist might visit with your child on the day of surgery to chat, play games or do other activities to help provide a distraction.

If you have any questions about your child’s anesthesiology prior to surgery, or if any significant changes in your child’s health occur before the day of the procedure, please contact us.

during surgery

Your child will receive the general anesthetic either through an intravenous tube, or through a breathing mask placed over the mouth and nose. Our anesthesia staff will monitor your child closely as the anesthesia is being given, and observe your child during the procedure to ensure his or her well-being and see if more medication is needed.

If your child is receiving a regional nerve block, additional anesthesiology team members will provide that. They are part of the acute pain team, which includes pediatric anesthesiologists and an advanced practice nurse.

At least one member of the anesthesiology team will be in the operating room at all times during your child’s surgery.

after surgery

After surgery, it usually takes about 45 minutes to an hour for kids to wake up from general anesthesia. A specially trained nurse will monitor your child in the post-anesthesia care unit or recovery room. During recovery, your child will still be under the care of the anesthesiologist.

The pediatric anesthesiology team at Dayton Children’s is committed to keeping your child’s post-surgery pain under control using a variety of techniques. This benefits your child in many ways:

• Less use of narcotic medication
• Less post-surgery nausea/vomiting
• A faster return of appetite and return of bowel function
• The ability to start rehabilitation therapy sooner
• Better rest and sleep during recovery
• Earlier discharge from the hospital

Pain relief strategies may include providing medication or a sedative through an intravenous tube. Another option is a computerized pump, which delivers pain relief medication on demand.

Before discharge, we will talk to you about how to minimize your child’s pain after returning home.