What Is Pediatric Anesthesiology?

When a child need surgery or other medical procedures, a pediatric anesthesiologist can assist in their treatment by administering medications to ensure the child is safe and does not feel pain.

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Types of Anesthesia

There are several different types of anesthesia:

  • General anesthesia. This common form of anesthesia puts a child completely to sleep. This allows the child to have a procedure or surgery without any pain, memory or movement. An anesthesiologist will inject medicine through an intravenous (IV) catheter placed in a vein or deliver anesthesia gas through a mask or breathing tube. Younger children will typically require general anesthesia for most surgical procedures.
  • Regional anesthesia. Regional anesthesia involves injecting medicine around nerves to numb a large area of the body. This type of anesthesia is used to keep children comfortable during and after the surgery. Regional anesthesia is usually used in combination with general anesthesia to maximize comfort and minimize anxiety during and after procedures.
  • Local anesthesia. An anesthesiologist injects medicine to numb a small area of the body. This type of anesthesia is usually reserved for minor procedures. Children will often be awake or receive minimal sedation with this type of anesthetic.
  • Monitored anesthesia care. This involves giving different sedating and pain-relieving medications through an IV to relieve a child’s anxiety and pain during minor procedures. They will not be completely asleep with this type of anesthesia. It is often combined with local anesthesia to minimize pain and anxiety.

Nonsurgical Procedures in Which Anesthesia May Be Used

Anesthesia and sedation are necessary for many procedures out of the operating room, too. These include:

  • Magnetic resonance imaging (MRI)
  • Computed tomography (CT) scans
  • Radiation therapy
  • Interventional radiology

What Parents Need to Know Before a Child Receives Anesthesia

To reduce the risk of aspiration (stomach contents entering the lungs) while under general anesthesia, your child will be asked to stop eating and drinking before the surgery or procedure.

The following is a list of fasting recommendations from the American Society of Anesthesiologists:

  • Stop 2 hours before procedure: Clear liquids (water, apple juice, Gatorade, Pedialyte)
  • Stop 4 hours before procedure: Breastmilk
  • Stop 6 hours before procedure: Non-clear liquids, non-human milk, formula, fluid thickeners, broth, Jell-O. Light meal with no fat or protein (toast and clear liquids, for example)
  • Stop 8 hours before procedure: full meal, solid food, fried foods, fatty foods or meat

Minimizing Discomfort for Your Child

The Child Life teams at RWJBarnabas Health facilities can provide distraction techniques, such as toys and tablets to distract your child during IV placement or going under general anesthesia. If your child has specific needs, please feel free to communicate them with the anesthesia team in advance, so they can accommodate your requests.

Risks and Side Effects of Anesthesia

Many children safely undergo general anesthesia for a wide range of surgeries and procedures. Your child will be continuously monitored throughout the process.

Potential risks and side effects from general anesthesia include:

  • Dental injury. Teeth that are already loose may get looser or fall off when we place a breathing tube or other devices in the mouth.
  • Sore throat. If a breathing tube is inserted in the throat, your child may have a temporary sore throat after it is removed.
  • Nausea or vomiting. There is a risk of some nausea when using anesthesia.
  • Emergence delirium. Your child may wake up irritable after anesthesia. This is usually temporary, and the anesthesia team will help your child calm down.
  • Allergic reaction. Allergic reactions to anesthesia may include hives, wheezing, swelling of the mouth, throat or eyes, and a drop in blood pressure.

Allergic to Anesthesia? Tell Your Doctor!

Serious allergic reactions to anesthesia are rare. However, if your child or a family member is allergic to any kind of anesthesia, be sure to tell your doctor prior to any procedure that requires it.

About Anesthesiologists and Their Roles in Your Child’s Care

What training does an anesthesiologist have?

Anesthesiologists must complete three years of general anesthesia training, followed by at least one year of specialized training in the use of anesthesia for infants and children before they can work alongside pediatric surgeons or other clinicians attending to children.

What is the role of an anesthesiologist?

Pediatric anesthesiologists are responsible for pain management, sedation and the general anesthesia needs of children.

How is an anesthesiologist involved in a child’s care?

Anesthesiologists evaluate complex medical problems in infants and children when surgery is needed, including the plan of care before, during and after surgery.

During surgery, the pediatric anesthesiologist works with the child to create a non-threatening environment in the operating room. They also attend to pain control, either through IV medicines or other anesthetic techniques.

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