Pediatric Patients

We recognize that fasting can be very difficult for all patients, especially our pediatric patients. Offices will typically schedule our youngest and smallest patients early in the morning to avoid prolonged fasting. If your child is scheduled later in the day, we recognize this can be difficult, but please know we are trying very hard to balance the needs of all of our patients.

Please do not send your child to school on the day of a surgery, they will eat.

Here are a few tips to make the process easier: feed them later in the evening than you normally would, allow them to sleep in as long as possible, tablets and screens are now your best friends, tale a long drive, or come to the office and watch movies in the waiting room.

Keep a close eye on your child. They are very good at finding food everywhere.

Just as family members are not allowed in the operating room at the hospital during procedures, we also do not allow family members to be in the room. This is a safety issue. We want all of our attention on your child. Any distractions or emotional outbursts during an emergency can decrease the safety of your child. Please know there will be at least two people in a room at any time with your child and will never be alone with anyone.

There have been no longitudinal studies done that show any side effects on the long term development in pediatric patients as a result of anesthesia.

Our primary objective is to keep patients safe during an anesthetic. We can provide anesthesia to many patients, but feel there are some that are not worth the risk of putting to sleep in the office.

These patients include anyone with a difficult airway due to congenital or disease processes.

We do not see patients with uncontrolled severe asthma, untreated epilepsy, or unrepaired congenital heart disease.

We do not see patients with down's syndrome in the office. These patients have a much higher risk of congenital heart disease, difficult airways, and atlanto-axial joint instability.

If there are specific questions about the suitability of a patient to be anesthetized in the office setting, please call us to discuss it with a CRNA. We are able to provide anesthesia to the vast majority of patients safely in the office.

We provide anesthesia to pediatric patients on a regular basis. Many of our patients are very small. Our anesthetics are not any more dangerous for smaller patients as compared to larger patients. In fact, most of our anesthetics are used in pre-mature infants at any age for simple procedures and for calming purposes. We will not provide anesthesia to any patient we are not certain we can safely anesthetize.

Your child will not be intubated, except in an emergency. We aim to provide a safe anesthetic in the least invasive manner possible. We have found our pediatric patients wake up so well following our anesthetics, in large part as a response to not being intubated.

Typically pediatric patients are done in 1-2 hours. There are certain occasions where your child will need to be asleep longer just due to the volume of work being done. The goal is to finish all necessary work in one appointment.

Recovery is 30-45 minutes after the completion of the procedure. Your child may feel dizzy or groggy for 1-2 hours after waking up.

We work with individual offices to set an age limit. Most of our work is with patients that require dental work. This typically gives us a minimum age of around 18 months. Please contact us for special circumstances less than 18 months.

A mild cough is not dangerous during an anesthetic. Morning coughs can be a response to many things. The coughs that concern us are persistent and constant. We will do a thorough interview and physical exam to determine the safety of any patient with a cough. Please plan on coming to the office or communicating with the CRNA of any cough before unilaterally canceling.

Please come into the office and be honest about what happened. We get that life is life. We have had patients find an old piece of pizza in the car before arriving at the office. Parents can only do the best they can. We will evaluate what the patient ate, how much, and when to determine how safe it would be to proceed. If your child ate, we will most likely need to reschedule the anesthesia for another time. We would much rather have a safe anesthetic than an expedient one.

We are prepared for all of the same complications in the office that we would be prepared for in the hospital. What we would need in a complication is more hands to help. We would call emergency services and direct them in our efforts to get them to a higher level of care. Our only concern is to get a patient through an anesthetic safely.

Yes! Please put them back to sleep for an hour or so when you get home. They will wake up feeling fantastic.

The most common side effects from our anesthetic are dizziness, nystagmus (twitching eyes), and a low grade fever. Please feel free to contact us if you have any concern about a side effect that seems abnormal.

We use many medications to make the anesthetic safe and as pleasant as possible when waking up. We will give a combination of antiemetics, anti-inflammatories, and pain relievers along with the anesthetic medication. The anesthesia is typically propofol and dexmedetomidine.

We give multiple types of anti-nausea medication to every patient every time unless there is a contraindication. We also avoid inhalational anesthetics and narcotics which increase the risk of nausea.

We have all the standard monitoring in the office that we would have in a hospital setting and as required by our safety and professional organizations. We will monitor your heart, blood pressure, oxygen, end tidal CO2, respiratory rate, and temperature in every situation.

All patients require the placement of an IV. This is the primary method of medication delivery and a safety protocol for emergencies. In the rare case your child allows us to start an IV, we will do so. In the majority of situations we will inject a fast acting, short duration anesthetic into the muscle of the arm or leg that allows us to start an IV without the patient feeling any pain or remembering the IV placement. Parents are with their child during this process.