• Biliary: cholelithiasis, biliary dyskinesia, choledochal cyst
• Pectus carinatum
• Endocrine disorders
• Gastrointestinal: appendicitis, intussusception, pyloric stenosis, malrotation, congenital anomalies of the GI tract from esophagus to anus, Gastroesophageal reflux, ingestion of foreign bodies (coins, batteries)
• Genitourinary:  circumcision (including neonatal), undescended testes, testicular or scrotal masses, testicular torsion, ovarian torsion
• Head and neck: dermoid cyst of the face or scalp, neck cysts (branchial cleft, thyroglossal duct), lymphadenopathy
• Other Congenital: Hirschsprung disease, anorectal & cloaca malformations, cystic lung lesions, esophageal atresia, trachea-esophageal fistula, diaphragmatic hernia, gastroschisis, omphalocele, intestinal atresia, lymphatic malformation; prenatal consults
• Subcutaneous masses
• Thoracic and abdominal tumors
• Trauma
• Tumors: kidney (Wilms), neuroblastoma, hepatic tumors/cysts, ovarian masses, abdominal and pelvic masses, lung and mediastinal masses

How and when should I prepare my child for anesthesia and surgery?

• Be honest with your child about where he or she is going. Do not lie to your child.

• Reassure your child that he or she will be asleep during surgery and will wake up after surgery.

• Reassure your child that a family member will be with him when he wakes up after surgery.

• Younger children (about 8 years and under) should have things explained in terms that he will understand. For example, you might tell your four-year old that he will have an operation to "fix his tummy" or to "make his tummy better" and that he will be asleep when he has his operation. It may also help to have your younger child pick one item, such as a favorite toy, blanket or stuffed animal to bring to the hospital for security.

• Older children and teenagers (about 9 years and older) should be given as much detail and information as you think they can handle. Try to encourage your child to ask questions. Help your child to think of ways to make waiting for surgery easier, such as bringing a book to read or music to listen to through headphones.

When should I prepare my child?

• You can begin to prepare your younger child a week or so before surgery by giving information about what will happen. If your child is 3 years or under, or very anxious, you might wait until the week of surgery or just a few days before surgery to start talking about it.

• Older children and teenagers can usually be prepared in advance of surgery at about the same time that you prepare. However, if he is very anxious or has a developmental delay, you might wait until the week of surgery to talk to your child in more detail.

These age ranges and guidelines are suggestions. All children are different. You know your child best and you should use your judgment about how and when to prepare your child.

This will vary by the age of your child, but in general, children cannot eat and drink after a certain time prior to their surgery. If you do not follow these fasting instructions and your child receives anesthesia, serious complications can occur, including death. It is extremely important that you follow the fasting schedule that has been discussed with you.

Pre-anesthetic Evaluation

After registering, you will have a meeting with anesthesia staff to discuss your child's current health and medical history before anesthesia can be administered. You may also ask questions and/or let staff know about any worries or concerns that you or your child have.

Waiting Room

• After the pre-anesthetic evaluation, you and your child will go to an area to wait for surgery.
• In the waiting room, your child may be given a medicine (called "premedication" or "premed") to help him or her relax before surgery. The premedication is often given in a liquid for your child to drink, but it can also be given in other ways, such as an injection.
• If your child will receive a premedication and how it will be given will depend on your child’s age (older children and teenagers may be less likely to need a premedication), medical condition and whether there is time for the medicine to work.

Going to the Operating Room

• Your child may be taken to the operating room on a stretcher or be carried.
• You may give your child a kiss and tell him that you will see him or her in a little while.
• Although care is taken to avoid making your child upset, separation may still cause some nervousness or anxiety.
• Medical staff will take good care of your child!

Anesthesia Induction

There are three major ways that your child may have anesthesia started (called "induction"):

• By mask, where anesthetic gas is given that your child will breathe (usually for smaller and younger children),
• By an intravenous ("IV") line, with anesthetic medicines (usually for older children) or
• By an intramuscular (IM) injection, (usually used when a child will not accept the mask or IV)

Your child’s anesthesiologist will decide the best method of anesthesia induction for your child.

Recovery Room

• After surgery your child will be taken to the PACU (Post Anesthetic Care Unit or the recovery room) to awaken. One parent or caregiver will be called to the PACU to be with your child, when he awakens. It is often best to have just one person remain with your child throughout the entire time in the recovery room.
• Your child may be groggy or sleepy from the anesthesia. Sometimes children do not behave like their typical selves when they recover from anesthesia. For example, your child might be fussy, cranky, crying and/or difficult to comfort.
• If your child will be admitted to the hospital after recovery, he will go directly to a hospital room from the PACU.
• If your child is going to be discharged following surgery, he will be taken to the outpatient recovery area for about an hour before discharge. Both parents can usually visit in this other recovery area.
• It is best for your child not to have a lot of family and friends at the hospital to visit your child before he or she is discharged. Your child needs to rest while recovering from anesthesia and surgery!
• Your child will be discharged when he has recovered from anesthesia.

After Discharge

• You will receive written instructions regarding the care of your child at home.
• On your child’s postoperative care instructions, there will be phone numbers listed for you to call if you have problems, questions or concerns about your child’s health.

What can I do to help make my child’s surgery go smoothly and safely?

• Arrive at your child’s scheduled appointment on time to avoid delays and delaying other surgeries.
• Follow all instructions carefully, especially NPO instructions.
• Remain flexible since emergencies or other uncontrollable factors may result in unexpected delays.
• Take care of yourself! Do not fast with your child- get up earlier than he and eat a good breakfast so that you are physically ready to provide emotional support for your child.

Written educational materials are available from the Ambulatory Surgery Center. Please call 501-364-1336 if you would like to request that either of the following pamphlets be sent to you.

• Helping Your Infant, Toddler, or Young Child Before Outpatient Surgery
• Helping Your Older Child or Teenager Before Outpatient Surgery

Before you go home, we will give you surgery discharge teaching information. This may include several pieces of paper. Please let your nurse know if you need a school or work excuse note.

We will explain: 

• What you need to know about taking care of your child after surgery.
• What you need to do in certain situations such as fever, vomiting, pain, etc. 
• How to contact someone for questions or concerns.
• Follow-up appointment(s).

“Teach Back” is a special way of teaching our patients and families to ensure that we are teaching the information in a way that makes sense to you. 

• We may ask you to show or tell us how to care for your child at home after surgery. 
• An example question: “What did I say to you about fever after surgery?”