The Day of Surgery - Main OR

On the day of surgery, a parent or legal guardian must accompany the patient.

• When you arrive, our staff will obtain a brief medical history and perform a physical exam. Some children may need a few simple lab tests performed, if not previously completed.
• Please bring all medical insurance information, such as insurance cards or forms. You will be required to present your photo ID at the time of registration. You are responsible for being aware of, and in compliance with, your insurance policy requirements. Be sure to check if insurance precertification is necessary.
• Please bring all legal guardianship or custody papers, when applicable. Also bring advance directive forms, if you have them.
• We are eager to help you receive your maximum allowable benefits and will be happy to process your insurance claim for you. However, we may need your assistance to communicate information to your insurance company.
• If you have any questions or are unclear about insurance coverage or billing practices, please call (614) 722-2055.

Anesthesia

What is anesthesia?
Anesthesia is the use of medicine to prevent the feeling of pain during surgery. There are two types of anesthesia. “General” anesthesia keeps a person completely unconscious (or “asleep”) during the surgery. “Local” anesthesia numbs only a small part of the body, the surgical site.

Who gives it?
All general anesthetics are given by members of the Department of Anesthesia.

The anesthesia staff consists of doctors specializing in anesthesia for children (anesthesiologists) and Certified Registered Nurse Anesthetists under the direct supervision of the anesthesiologists. In addition, resident physicians, fellows and registered nurses may be present, each working under the direct supervision of the anesthesiologists.

Will I be able to talk with an anesthesiologist?
Yes. An anesthesiologist will review the preoperative assessment with you prior to surgery, discussing the anesthesia and answering questions. If you have concerns about your child’s anesthesia and would like to speak to an anesthesiologist prior to the day of surgery, contact the Nationwide Children’s Main Operating Room at (614) 722-5200 or Nationwide Children’s Pre-Admission Testing at (614) 722-3850.

Will my child get a “shot” before surgery?
If sedation is needed for younger children, it will usually be given in the form of a liquid to swallow, rather than by injection. Older teens and adults may have an injection. Sedation may be omitted entirely in some cases. These options can be discussed with an anesthesiologist. Will I be with my child until he/she goes to sleep? The attending anesthesiologist makes this decision.

How is the anesthesia given?
The induction (start of anesthesia) for younger children is accomplished by inhaling non-irritating, medicated air delivered through a mask placed near the nose and mouth. Your child may choose a scent for this mask. After three or four minutes, your child will be asleep.

Older children and some children with medical problems might require the induction of anesthesia with intravenous medication. A patient’s preference is accommodated when appropriate, but the anesthesiologist will make the final decision based on the child’s safety.

During the induction, an anesthesiologist is always present in the operating room, along with at least one other staff member. Together, they work to provide the best possible operating conditions for the surgeon, while maintaining a safe level of anesthesia for your child. While we offer the opportunity for a support person present in the induction room, the anesthesiologist will make the final decision.

In some cases, a plastic breathing tube will be inserted into the windpipe to aid in breathing. Intravenous fluids and other medications may be given, as required.

Monitors are used to help us check your child’s vital signs throughout the operation and recovery period. These monitors include a blood pressure cuff, heart monitor, thermometer, pulse oximeter, and oxygen and carbon dioxide monitor.

We are concerned about the comfort of your child. The management of pain after surgery will be decided by the individual anesthesiologist. This may include intramuscular and intravenous pain relievers or a nerve block with a long-acting, local anesthetic.

Where does my child wake up?
Your child will recover in the Post Anesthesia Care Unit (PACU). Nurses trained in this phase of recovery provide specialized care. An anesthesiologist is always available should problems arise. Our goal is to have your child back with you as
soon as possible.

After Your Child’s Surgery

The surgeon will speak with you after surgery. The nurses will answer any questions and give you step-by-step verbal and written instructions, as ordered by your surgeon.

Will my child be nauseated after surgery? What other problems can I expect?
A small percentage of children will be nauseated or vomit after surgery. Children having eye surgery or tonsillectomies are more likely to have this problem. Medication is available if the nausea persists.

If a breathing tube was inserted, your child may have a sore throat or hoarseness for a few days. Intravenous lines (IVs) are placed in almost all children after anesthesia is given. There may be a puncture mark or bruise at the site.

Will there be any behavioral changes after surgery?
Children handle the hospital experience in a variety of ways. These are some things that your child might exhibit:

• It is not uncommon for a child’s behavior to regress.
• Some children may have trouble with separation and become more dependent on adults.
• Sleeping and eating patterns may change.

Remember, these changes are common and temporary. If you have concerns, please talk to your doctor. In the event of any problems after you arrive home, please call your surgeon’s office, which is listed in your surgery discharge papers. You will be given written discharge instructions that include telephone numbers.