Pediatric Anesthesia and Pain Management

Anesthesia care for children is significantly different from anesthesia care for adults. Pain management for pediatric patients is also much different. Even beyond the pharmacological and physiological differences behind anesthetic techniques and drug choices, there are key differences between pediatric and adult anesthetic care and pain management that every anesthesia provider should embrace. 

Emotional Aspects of Pediatric Anesthesia and Analgesia 

Having a sick child is stressful for parents. Even for minor, common pediatric procedures such as ear tube placement, the stress for parents is real. It is important for anesthesia providers to be sensitive to this reality and provide compassionate care to not only their pediatric patients, but their parents as well. When children are old enough to sense the concern of their parents, they may also become stressed about their procedure. An ability to display compassion while comforting pediatric patients is paramount for pediatric anesthesia providers.

How to Prepare Pediatric Patients and Parents

Thoughtful communication with the pediatric patient’s family should be done without being rushed. After educating the patient and their family on what to expect, allow plenty of time for questions. The anesthesia provider should provide parents and children with information about anesthesia induction and equipment that will be used to reduce anxiety. Parents should have an understanding of what types of anesthesia will be used in order to have a better idea of how their child will present after surgery. Managing expectations is valuable when it comes to communicating with parents. 

The Anesthetic Plan for Pediatric Patients 

It is critical that the anesthesia provider pick appropriate anesthetic drugs and properly prepare the surgical space. The child’s age, weight, known allergies, health record and surgical record are all influential factors in developing a pediatric anesthesia plan. However, the type of case is perhaps the most important factor in developing the pediatric anesthesia plan, as outpatient cases may be better suited for topical or regional anesthesia, while more invasive surgeries will require general pediatric anesthesia. The anesthesia provider should also collaborate with other OR team members to prepare the OR with appropriate-sized equipment. 

Postoperative Pain Management for Children 

Pediatric postoperative pain management should be based on the patient’s own perception of pain using a pain management “ladder.” There are other age-specific pain assessment tools for children that can give a better understanding of appropriate analgesics that should be used. For example, a commonly used assessment tool is the Wong-Baker FACES Rating Scale where children are asked to look at and choose from six different faces that depict expressions associated with no pain to varying levels of pain that may or may not be associated with crying. There are other similar assessment tools that anesthesia providers should be accustomed to using. 

In addition to monitoring postoperative pain, pediatric patients should be monitored after surgery to avoid potential complications. Since pediatric patients may not be able to verbalize any irregularities they may be feeling, close monitoring after surgery is essential. Once the pediatric patient has been cleared for discharge, their family should be given detailed instructions for pain management with a highly structured format. This will help ease anxieties surrounding recovery and increase satisfaction among patients and their families.

If you are interested in learning more about how your facility can improve in areas related to pediatric anesthesia, contact us today. Not all anesthesia providers are suited for the challenge of delivering pediatric care, but CCI Anesthesia is experienced in finding the best, most compassionate and patient providers for these special roles.