Stony Brook University Hospital Department of Anesthesiology

Division of Pediatric Anesthesia

PEDIATRIC ANESTHESIA FOR AN AMBULATORY AND SAME DAY PROCEDURE

• Who will provide anesthesia?
• The division of pediatric anesthesiology at Stony Brook University Hospital provides anesthesia services at the main hospital and at the ambulatory surgery center. A team consisting of our anesthesiologist working with residents and certified nurse anesthetist will care for your child.
• May I choose my pediatric anesthesiologist?
• Many parents find their doctors through recommendations from their primary doctors or through family and friends. You do have a choice within our team but you must make that choice known in advance. Most of the patients are satisfied with whom they are assigned. Should you have a preference, every effort will be made to honor that request.
• What are the different kinds of anesthesia?
• There are four main categories of anesthesia; general, regional, monitored anesthesia care and local anesthesia. Regardless of the category of anesthesia your child may receive, special anesthetic agents and techniques will be used to provide a safe and speedy recovery.
  1. General Anesthesia- the child is not conscious and has complete loss of sensation. This technique involves inducing sleep of the whole body, and the brain.
  2. Regional Anesthesia- local anesthetic is injected by the anesthesiologist to provide numbness and loss of sensation to a region of the body. This could include spinal anesthesia, epidural anesthesia, upper and lower blocks. Additional intravenous medication may be given to make the child comfortable and drowsy.
  3. Monitored Anesthesia Care- during this type of anesthesia the surgeon usually injects local anesthetic to the site of surgery to provide numbness and loss of sensation. The anesthesiologist then supplements this with intravenous medication to make the child comfortable and drowsy.
  4. Local Anesthesia- local anesthetic is injected by the surgeon to provide numbness and loss of sensation to a small area.  This technique is rarely performed in the pediatric group.
  We sometimes offer a combination of these modalities of anesthesia. The reasonable choices available for the surgery will be discussed with the anesthesiologist before the surgery.
• May I request the type of anesthesia for my child?
• Yes, in certain situations. Some operations can be performed using a choice of different anesthetic types. Your anesthesiologist will discuss available options with you after reviewing the medical history. Your preference will be discussed so that the most appropriate anesthetic plan is made.
• Will my child receive any sedatives before surgery?
• 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 a procedure. This medication may be given by mouth or injection. The time and type of such premedication will vary and will be determined by the anesthesiologist.
• What are the risks of anesthesia?
• No procedure is without some degree of risk, which your anesthesiologist will discuss with you prior to the procedure. Fortunately, serious and major complications such as strokes and deaths from general (or other types of) anesthesia are very rare today, despite the fact that more procedures are being performed on sicker and younger patients than in the past. In the last 10 years, the estimated numbers of deaths attributed to anesthesia (for all types of surgical procedures) have dropped significantly to 1 in 250,000. Serious complications such as strokes and prolonged periods of mechanical ventilation have also declined over the past few decades. The increased safety of general anesthesia is due to many factors, including: safer drugs, more extensive training of anesthesiologists, and national standards of care. However, minor problems- most of which are easily treatable- such as nausea and vomiting, sore throat, dizziness, tiredness, headache and pain may occur.
• Will the anesthesiologist bill me separately?
• You will receive separate bills for different professional services. Stony Brook Anesthesiology, P.C. participates in most health plans. If you have any financial concerns, you may call our anesthesia office, Tel- 631.444.2975.
• May I enter the operating room with my child?
• There will be circumstances where it is appropriate for a parent to come into the operating room. Studies and experience show that this decision needs to be individualized and discussed between you and your anesthesiologist. There are many situations where other choices are better and possibly even safer. Please do not hesitate to discuss your options.
• Why must my child refrain from eating and/or drinking prior to surgery?
• The reason for fasting prior to surgery is to reduce the risks of aspirating gastric contents during the surgery. This complication, although rare, is very serious and parents need to strictly follow our recommendations. This has nothing to do with nausea and vomiting after the surgery.  We have very clear policies as to specific ages and time periods before surgery when the child must refrain from eating and/or drinking. These are all based on safety standards. We believe that the fasting time should be as short as possible before the surgery.
• Home medications?
• Generally we request that you give most medications on the morning of surgery. This should be discussed with your surgeon who will contact us with any questions, and refer you for a preoperative consultation if necessary. Medication may be taken with a sip of water on the day of surgery. Please bring in all medications with you on the day of surgery.
  Some medications will be stopped for the surgery, particularly diabetes medication and blood thinners (rarely seen in the pediatric group). You should bring these medications with you the day of surgery. Please call us with any questions you may have.