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Pediatric Surgery

 

When your child needs medical treatment, you want him or her to have the very best care available.

So it stands to reason that if your child needs an operation, you’ll want to consult with a surgeon who

is qualified and experienced in operating on children.

 

 

Pediatric Anesthesia

The most common anesthesia for children having surgery is general anesthesia.  This is a special

kind of sleep brought about by anesthetic medications.  Once asleep, your child will experience no

awareness or pain.  Since young children tend to be afraid of needles, our anesthesiologist will most

likely administer general anesthesia in the form of a gas your son or daughter will breath through a

plastic mask.  Anesthesia can also be given as medication through an intravenous (“IV”) line, which

is the usual technique for older children and adults. During general anesthesia, your anesthesia

team's most important responsibility is to monitor your child and keep him/her safe, sleeping, and

comfortable during the procedure.  After the surgery is over, your anesthesia team member will wake

your child up.

 

In addition to general anesthesia, your anesthesiologist may recommend other anesthetic medications and techniques to help improve your child’s level of comfort and pain management.  These include the injection of local anesthetic medications (“numbing medicine”) around the surgical area, or around the nerves that transmit pain sensation in the part of the body undergoing the procedure.

 

 

Before Surgery

Prior to your child’s surgery, a nurse will call you to discuss when to arrive at the Novi Surgical Center, what to bring with you, and the pre-operative fasting instructions. The nurse will also do a general health assessment and gather a medical history over the phone — as well answer any of your questions. Let the nurse know of any changes in your child’s health (a fever, runny nose, sneezing, coughing).

 

Instructions for fasting prior to surgery:

 

Patients under 16 years of age:

* Drink only clear liquids 2 hours before arrival (such as Pedialyte® or water).  No fluids 2 hours prior to arrival.

* If breastfeeding, breast milk can be consumed up to 4 hours before surgery.

* If formula feeding or drinking milk, stop 6 hours before surgery

* No solid foods 8 hours before surgery.

 

Patients over 16 years of age:

* No solid food 8 hours surgery.

* May drink clear liquids up to 4 hours before surgery (water)

 

Additional instructions:

* Notify our office if your child develops sign of illness at least 3 weeks prior to the scheduled date of the surgery. Symptoms, such as fever, sore throat, cough, runny nose, rash or injury should be reported immediately.

* Teeth may be brushed on the morning of surgery, but try not to swallow any of the water used.

* Any medication your child is on should be discussed prior to the surgery with the doctor for instructions pre-surgery.  Also, go over again with nurse.

* No jewelry is to be worn by the child at the center. If your child wears glasses or a hearing aid, please bring a case for storing it during the surgery.

* Loose fitting clothing should be worn by the child.  Bring a bottle or cup with lid for use after the surgery.  A toy and/or a special blanket can be brought for child.

* The parent or legal guardian of the child is required to remain at the Novi Surgical Center throughout the surgery.

If you have any concerns or questions, feel free to contact the Novi Surgical Center at 248-477-2200.

 

 

Day of Surgery

Make sure to allow plenty of time to get to The Novi Surgical Center, park your car, and get registered at the front desk.  Once you arrive, the receptionist will review the registration information with you. You and your child will then remain in the waiting lounge until your nurse meets you and brings you back to the preoperative holding area. That’s where the nurse will conduct a brief examination, including taking your child’s temperature, and measuring his/her height and weight. Your child will be given a gown to change into.  You will then meet your anesthesia team who will inquire about your child’s medical condition and discuss the anesthesia plan with you, including the risks and benefits of the particular type of anesthesia that will be administered. Be sure to ask any questions you have about the anesthesia at that time.  Before going to the operating room, your surgeon will meet with you, examine your child, and answer any additional questions about the surgery.

 

It is normal for your child to feel scared or anxious on the day of surgery – not only at the thought of the procedure but also by the unfamiliar surroundings, faces and sounds.  The anesthesiologist will often prescribe a sedative anesthesiologist to calm your child and help reduce his/her anxiety.  Young children are given this sedative to take by mouth in the form of a flavored liquid.  Older children and young adults will have an intravenous (“IV”) line placed in the preoperative holding area, and can also receive an injectable medication to help with anxiety.  In most cases, a parent will be allowed to accompany the child into the operating room and stay until the child falls asleep from the anesthesia. Once your child is asleep, you will be asked to wait in the waiting lounge.  There, you will receive regular updates on the progress of the surgery or procedure.  Make sure the staff has your cell phone number if you have to leave the Surgery Center for any reason.

 

 

After Surgery

Following the surgery, you will be allowed to re-join your child in the recovery room. Your son or daughter will be taken care of by a recovery room nurse who is experienced in pediatrics, and certified in pediatric advanced life support (PALS).  The nurse will continue monitor your child’s vital signs and breathing, as well as be alert to any problems arising from the procedure or anesthesia.  It is normal for children waking up from general anesthesia to feel drowsy and disoriented. However, these symptoms will improve progressively during the recovery room period and during the first 24 hours after surgery. If your child experiences significant pain or nausea in the recovery room, the nurse will take immediate steps to treat it.  Once your child is sufficiently awake, he/she will be offered something to drink.  (Babies will be allowed to nurse and drink breast milk at this time.) After your son or daughter has met the discharge criteria and is sufficiently recovered from anesthesia, he or she will be discharged and you will be given the appropriate post-operative instructions.

Here are some general post-operative guidelines:

 

* Do not give your child food or drink in the car on the way home.

* Make sure to follow all of your physician’s instructions, especially regarding diet and activity.

* Once home, your child should be closely accompanied for at least 24 hours.  If any problems develop, please seek immediate medical attention.

* A member of the K and B Surgical Center staff will call you the next day to check on your child’s progress and answer any questions you may have.

 

 

Frequently Asked Questions

What items do I need to bring to the Center on the day of surgery?

* Parent’s photo identification (drivers license or passport).

* Child’s health insurance card or information.

* A favorite small toy or blanket for child.

* If your child wears glasses or contact lenses, bring a carrying case to store them during the surgery.

 

What is meant by “clear liquids?”

Clear liquids include water, apple juice, Pedialyte® or any other liquid you can completely see through without any floating material visible.

 

Should my child take his/her medication before surgery?

You’ll be given instructions as to which medicines are acceptable and which are not. Most medications can be continued as scheduled, right up until the morning of surgery and taken with a small sip of water. However, some medications should not be taken at all, or administered in a smaller dose. If you’re unsure, it’s always best to check with your doctor before giving your child any medications before the surgery. If your son or daughter has asthma and uses an inhalant, please bring it to the Center with you on the day of the procedure.

 

What if my child become ill prior to surgery?

Contact your surgeon or pediatrician right away if your child develops a cold or fever prior to surgery.  The child’s breathing while under anesthesia can sometimes be affected by illness.  However, in some cases of mild colds, it may still be safe to undergo anesthesia. If your child has a fever, this may mean he/she has an infection and therefore, it would be best to postpone the procedure until your child has fully recovered.

Making the decision to move forward with surgery will be made by both your anesthesiologist and surgeon based on your child’s medical history and condition.

If surgery is postponed because of a cold or illness, it is customary to wait a few weeks to allow for your child’s breathing passages to return to their normal condition.

 

Should I discuss anesthesia with my child? 

Your child may have many questions, and talking with your child about what to expect during surgery and anesthesia is important. Once you have learned about the procedure, be honest and comforting about why your child is going to have the procedure. Explain in simple terms and continue to comfort and reassure that you’ll be there throughout the procedure.

 

Listen carefully to your child, and support his/her feelings.  Be patient during this stressful time.  Explain that being frightened is normal. Don’t be surprised if your child resorts to acting out as a result of being stressed, but this behavior usually improves after the surgery is over.

 

When’s a good time to start talking to my child about the surgery?

Discuss the surgery before it happens.  Timing will depend on age and the level of the child’s learning and memory ability. Discussing the subject too early may actually increase anxiety. You may want to allow your son or daughter to begin asking questions, then you know it is a good time to start the conversation. A good rule of thumb is 1 day prior to surgery per year of age.  A seven year old should know about his or her surgery about a week in advance. 

 

What if my child experiences pain after surgery?

You are certainly aware of your child, and are the best to sense if he/she is not comfortable or in pain. We will ask your child about whether he/she has pain, and we will continually observe Infants’ and toddlers’ behavior for signs of pain. Our staff is very familiar with the usual pain and discomfort associated with various procedures, and can ask the physician to prescribe medications if necessary. Pain medications can be given to children by mouth in the form of pills or liquids, through an IV, or as rectal suppositories.