Our staff are experts in caring for children and their families. A team of nurses, surgeons and anesthesiologists will provide your child's surgical care, and they will do everything possible to make your experience safe, convenient and comfortable.

This information will help you to prepare your child and answer any questions you may have. However, if you still have questions after visiting this site, please call us at 267-425-4300.

Preparing your Child for Surgery

Anesthesia
General Anesthesia
General anesthesia provides complete pain relief and loss of consciousness during surgery. Your child will sleep through the procedure and wake up with no memory of what happened. The anesthesia team is specially prepared to prevent as many side effects as possible, such as temporary slowing of breathing and heart rate and lowering of blood pressure. Even so, surgery stresses the body and may cause your child to become nauseous and/or vomit, also normal side effects after surgery and anesthesia.

Regional Anesthesia
Regional anesthesia provides pain relief to specific areas of the body, similar to the medicines used by the dentist before dental work. There is no loss of consciousness.

Often, general anesthesia is used with regional anesthesia, permitting the anesthesia team to give less sedating general anesthesia to your child. Your anesthesiologist and surgeon will be glad to discuss the pros and cons of each kind of anesthesia with you.

Administration of Anesthesia
Anesthesia may be administered in several ways. Mask or inhalation induction allows your child to breathe anesthesia medicines until he or she falls asleep. With this approach, needle sticks are done after your child is asleep. Anesthesia medicines can also be given by intravenous injection, a method which is most often used for adults, but may also be used for older children. Your anesthesiologist will talk to you about the best method for your child.

On the day of surgery, your anesthesiologist will meet with you to discuss the anesthesia plan. You and your child can ask questions and express any concerns at this time.

Anesthesia and Minor Illnesses
Sometimes, minor illnesses, such as the sniffles or colds may cause problems during surgery and anesthesia. For this reason, your anesthesiologist may feel it is best to postpone surgery.

Please notify your surgeon's office if your child:

• has been exposed to infectious diseases such as measles, mumps or chicken pox;
• has cold symptoms such as a cough, runny nose or fever;
• has any change from his or her usual health;
• if your child has had any aspirin or ibuprofen (Advil or Motrin) or products containing aspirin or ibuprofen within two weeks of the surgery

Preparing to Care for Your Child at Home After Surgery
It will be easier to care for your child after surgery if you stock up on a few items before the day of the operation.

We suggest having the following in the house upon your return home:

• Soup
• Popsicles
• Clear Liquids: apple juice, soft drinks, Gatorade or Kool Aid
• Aspirin-free pain relief medications such as Tylenol

The Day Before Surgery
The day before surgery, call 267-425-4699 between 3:30 and 6 p.m. for your child's arrival time. For a Monday surgery, call on a Friday. If you have special arrival needs, please notify your surgeon's office when scheduling the surgical date.

Eating and Drinking Restrictions
The most important thing you can do for your child is to follow these feeding instructions. Your child's surgery may be delayed or cancelled if these instructions are not followed.

Stop all food at midnight the evening before surgery. This includes the following:

• formula
• juice with pulp
• milk
• hot or cold cereal
• solid food
• pudding
• milk products
• orange juice
• chewing gum
• candy

Breast Feeding
Because breast milk is different from formula, you may breast feed your child until three hours before your scheduled arrival time.

Clear Liquids
The clear liquids listed below are permitted until two hours before your scheduled arrival time:

• apple juice
• Gatorade
• Juicy Juice
• water
• soft drinks and soda
• Jell-O
• Kool-Aid
• water ice or Popsicles
• clear broth

Important Tips

• The day of surgery can be long and stressful. We will make every effort to reunite you with your child as soon as possible. For safety reasons, however, only adults are allowed in the recovery room (called the Peri-Anesthesia Care Unit or PACU). Please make arrangements for the care of your other children so that you can be with your hospitalized child.
  
  
• After the operation, your child may be sleepy or uncomfortable. We suggest that you arrange for a car or taxi ride home. Please do this before the day of surgery.
  
  
• On the day of surgery, your child must be accompanied by a parent or legal guardian. We request that this person remain at the hospital during the child's stay.
  
  
• Please call your surgeon's office if your child has been exposed to any infectious diseases such as measles, mumps or chicken pox, has cold symptoms such as a runny nose or fever or any change from his or her usual health. Also notify your surgeon if your child has had any aspirin or ibuprofen (Advil or Motrin) or products containing aspirin or ibuprofen within the two weeks before the surgery.

What to Bring to the Hospital

When You Arrive at the Hospital
Directions, parking and arrival
If you need directions to Children's Hospital (or to one of our satellites), you can enter your starting address on our directions page and get customized directions.

Where to Go
Surgery is located on the 4th floor of the Hospitals MainBuilding. Please park in the Wood Center Garage located off of Civic Center Boulevard. (Turn off of Civic Center Boulevard at the traffic light onto Osler Circle. Proceed to the garage entrance). A security officer will be at the parking garage entrance if you have any questions. Take the Wood Center elevators to the 3rd floor and follow the signs to Surgery Reception.

Before Surgery
After checking in, you and your child will be escorted to an exam room. Your child will change into hospital pajamas and a nurse will check your child's temperature, heart rate, blood pressure and oxygen level. The nurse will also listen to your child's breathing and get an update on his or her health status, including any medicines or illnesses.

You and your child will then return to the registration area.

Next, you will meet with the anesthesiologist to discuss the anesthesia plan.

Just before going to the operating room. Most children will be given a medicine that can make them giggly, sleepy and unsteady. Once this medicine is given, children are in danger of falling and may not walk around.

During the Operation
We will show you where to wait while your child is in surgery. While you are waiting, a nurse will give you an update on your child. Please remain in the waiting area because your surgeon will look for you there when the surgery is over.

We will make every effort to reunite you with your child as soon as possible. For safety reasons, only adults are allowed in the recovery room. Please make arrangements for the care of your other children so that you can be with your hospitalized child. Also, please note that a parent or legal guardian must accompany the child on the day of surgery and remain at the hospital during the child's stay.

After Surgery
After the operation, your child will go to the Peri-Anesthesia Care Unit (PACU). You will be taken to this room to be with your child after he or she awakens. For safety reasons, only two adults may stay with PACU patients.

Your child may look puffy or swollen after surgery. He or she may be receiving oxygen, have an I.V., or may be attached to a heart monitor. A nurse will check your child's heart rate, breathing, blood pressure or temperature regularly.

What can I do for my child in the PACU?

• If your child is sleeping, please do not wake him or her up.
• Speak softly and calmly. Reassure your child.
• Respect the privacy of other patients and focus on your child.
• Do not use cellular phones or laptop computers. They may interfere with monitoring equipment.
• If there is an emergency on the unit, you may be asked to leave the room.

Pain Control
The Pain Management Team, consisting of your child*s surgeon, anesthesiologist and nurse will decide upon the best kind of pain relief for your child.

Waking Up from Anesthesia
Each child wakes up differently. Some are wide awake in the recovery room. Others are groggy for hours. Some are very confused and agitated for ten minutes to one hour after the surgery.

Approximately one third of children, especially those under six, experience 'emergence delirium.' They appear to be awake, but are not really aware. During this time, the child may cry, thrash and reach for the parent. Nothing seems to calm the child. Is is upsetting to watch but usually goes away by itself. Your nurse will make sure that your child is safe. Sometimes, a quiet, dark room can help the child go back to sleep. Usually, it just takes time for the effects of anesthesia to wear off. Try to stay calm and comfort your child. He or she will not remember this excited state and often, will wake up feeling fine.

If an overnight stay is planned, your child will go from the PACU to a hospital room. If an intensive care stay is required, your child may go directly from the operating room to the Pediatric Intensive Care Unit (PICU).

Going Home
If your child is going home on the day of surgery, he will be discharged from the PACU. Our staff will decide when your child is ready to go home.

You will receive written information on how to care for your child. We will also discuss activity, medicines, special care, follow-up appointments, what to expect and where you can call with any questions.

Activity
Your child may be unsteady for the first 24 hours and will need to be watched closely.

Feeding
Your child may start eating and drinking slowly. First, try clear liquids like water, ginger ale, apple juice and Popsicles. If your child does not vomit, try a light meal like soup, crackers or eggs. Do not force your child to eat, but do encourage fluids.

Pain
Your child may have some pain, be cranky or run a slight fever. Acetaminophen, such as Tempra or Tylenol may be enough to keep your child comfortable. If needed, your surgeon will provide a stronger or different medication.

Behavior
Some children have temporary behavior changes at home, such as changes in sleep patterns, clingy behavior, eating changes, hyperactivity, new fears (not wanting to sleep alone, needing a night light) and acting younger (bed-wetting, thumb sucking). This behavior is temporary and normal. Here are some ways you can help:

• Assure your child that he or she is safe and well.
• Read books about hospitals and doctors.
• Play hospital.
• Make a hospital scrapbook.
• Distract your child with games, toys and music.

If these behavioral changes last longer than you expect, please call your surgeon's office. We want you and your child to have a good stay with us. If you have any questions, comments or concerns, please call 267-425-4300, Monday through Friday, 7 a.m. to 7 p.m. Someone will return your call as soon as possible.