Pediatric Anesthesia with Jose Dominguez, MD
How does GBMC prepare kids for anesthesia?
Undergoing anesthesia can be frightening for pediatric patients and their parents. But when the anesthetic approach is individualized for the patient’s age and type of surgery, the experience is often more bearable.
According to Jose Dominguez, MD, Pediatric Anesthesiologist at GBMC, both pediatric and adult anesthesia use the same drugs. “What differs is how they are administered to children and how their bodies respond,” he says.
One of the major differences between adult and pediatric anesthesia is communication with the patient. “When caring for the adult patient, you can discuss procedural details and anesthetic risk openly, one-to-one,” says Dr. Dominguez. “When caring for a child, you are working with two patients – the adult or parent and the child. You need to be able to communicate at both levels simultaneously to retrieve and convey information without making the child feel threatened.”
It is important that physicians who work with children be cognizant of how much and what kind of information children can process at different ages. “Between the ages of three and eight, children may be afraid of getting shots, experiencing pain and being separated from their mom and dad,” says Dr. Dominguez. “Children between the ages of 11 through 17 are self conscious about their bodies, having their clothes removed and losing control. In addition, they are fearful about waking up in the middle of the procedure.”
At GBMC, several steps are taken to ensure the comfort of all pediatric patients. “For younger children, we allow parents to be present during the procedure to give a child a sense of security,” says Dr. Dominguez. “With older children, we reassure them they will be warm and covered the entire time.” Less commonly, an oral sedative can be administered preoperatively for children who have had multiple medical procedures. In addition, GBMC offers an opportunity for children to tour the facility before surgery and see where they arrive, what they wear and meet some of the people who will be involved in the procedure.
According to Dr. Dominguez, pain management is an important consideration with pediatric anesthesia. “With children there is a huge emotional component to pain,” he says. “We try to get the pain under control before they wake up. When a child cries in the recovery room, it is often not because they are in pain, but because they are disoriented.”
In addition to comforting children, pediatric anesthesia often involves comforting parents. “A lot of times parents wonder if their child will survive the anesthetic,” says Dr. Dominguez. “We try to put some perspective on how likely complications are to happen. For healthy children, there is a greater risk with driving to the hospital than there is of them dying from the anesthetic. They also want to know if they can be with their child when he or she wakes up, so the recovery room nurses make every effort to bring the parents back as soon as the child starts to wake up.”
