At Arkansas Children's, our pediatric anesthesiologists are faced with the challenge of providing anesthesia for infants and children. They are uniquely prepared to meet the physical, developmental, psychological and emotional needs of infants, children and adolescents who require anesthesia or sedation.
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, the psychological needs of our patients 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.
At Arkansas Children's our Parent Present Induction (PPI) program is used to reduce stress and anxiety in children who are going to receive an anesthetic. A parent who wishes to be present with the child when he or she goes to sleep (induction) may do so if the child meets certain criteria and the anesthesiologist agrees. Patients who are undergoing emergency surgery or who are extremely ill may not be eligible. In all cases the decision of the Anesthesiologist is final.
There are many important things that the anesthesiologist must consider when deciding whether or not to offer PPI.
Below are some of the key points:
The anesthesiologist must consider the condition of your child. The safety of your child is our first concern.
Remember your child must be NPO (no food or drink) for several hours before surgery as explained by your doctors and nurses.
Anesthesia induction can be started in a number of ways:
Many children receive a special medicine before induction to help calm them. This "premed" or "goofy juice" is not always used, and with PPI may not be necessary because you will stay with your child until they are asleep. Most children who have a PPI will breathe medicine through a special mask; however, it is sometimes necessary to use one of the other two forms of induction (IV or IM).
If you are able to come with your child for the induction, there are two stages of behavior you will see:
During this stage the child is aware of what is happening around them. It is normal for children to become anxious during induction.
They may try to:
Some children who experience these behaviors may require gentle restraint to complete the induction process.
In the second stage of the induction, children become unaware and are unlikely to remember the events that take place or their behaviors.
Your child may:
The anesthesiologist will let you know when it is time for you to leave the induction or operating room. Your child may not appear to be asleep when you leave the room because his or her eyes may still be partially open. It is important for you to realize that your child is unaware of your presence or you are leaving at this point.
Finally, we would like to remind you that we would never require you to choose PPI. We understand that this is an individual choice and if you do not feel comfortable or prepared to go back to the induction with your child we will not ask you to do so. Our caring staff is dedicated to providing your child with the highest quality of care whether or not you are present for your child's induction.