The anesthesia will be provided by a Dentist Anesthesiologist or Certified Registered Nurse Anesthetist. It is the anesthesia provider’s job to keep your child safe and comfortable during surgery and during recovery from anesthesia. The anesthesia provider never leaves your child’s side until he or she is safe and stable in the recovery area.

Your anesthesia provider takes several factors into account when recommending the type of anesthesia. Some of those factors include the type of surgery, the surgeries expected length as well as your medical history. These types of anesthesia are not always clearly defined, and patients may progress from one level of sedation/anesthesia to a lighter or deeper level during the procedure. For this reason, the American Society of Anesthesiologists (ASA) considers anesthesia a continuum, from light sedation to general anesthesia. Understanding that the level of sedation/anesthesia is a continuum, the ASA has published the following definitions:

Minimal Sedation
A level of sedation that relieves anxiety but preserves consciousness. The patient is typically relaxed but readily responds to verbal commands. Blood pressure, heart rate and respiratory function are generally unaffected.

Moderate Sedation
A level of sedation that depresses consciousness and relieves anxiety and pain. Under moderate sedation, purposeful response to verbal command or light tactile stimulation is maintained. Blood pressure, heart rate, and respiratory function are generally unaffected or minimally affected.

Deep Sedation
A level of sedation in which the patient is not easily aroused, but responds purposefully to repeated or painful stimulation. Blood pressure and heart rate are generally maintained, but intervention may be required to maintain respiratory function.

General Anesthesia
The patient is completely unconscious, and not responsive to painful stimuli. Blood pressure, heart rate and respiratory function are often compromised.

Generally, children are anesthetized by allowing them to breath a little anesthetic gas through a facemask. We add your child’s favorite flavor to the mask and play different distraction games to help ensure your child has a smooth transition to “sleeping” under general anesthesia. After your child is asleep, an IV is usually started. Selection of appropriate anesthetic agents is dependent upon many factors.

Your child’s heart rhythm, blood pressure, the amount of oxygen in your child’s blood, temperature, and level of consciousness will be monitored closely by his or her anesthesia provider.

NPO is a medical abbreviation for “nothing by mouth”. It is very important to adhere to the fasting guidelines established by the American Society of Anesthesiologists. If child’s stomach is not empty, he/she may vomit and aspirate stomach contents into lungs. For this reason, we recommend to not consume food after midnight. However, if the surgery is late in the day, child may eat as indicated in the table below. Additionally, please avoid breath mints and chewing gum. If criteria is not followed, your child’s procedure may be postponed or cancelled.

Be sure to ask your doctor which medications your child should take on the day of surgery. Most medications can be continued as scheduled, right up until the morning of surgery and taken with a sip of water. Tylenol (acetaminophen) or Advil (ibuprofen) may be taken for pain. We suggest your child receives his or her usual dose of any inhalers/nebulizers for asthma or reactive airway disease the day of the procedure. Diabetes medications need to be discussed. Please call your anesthesia provider.

Consult your doctor’s or dentist’s office if your child has a fever, flu-like symptoms, or another major illness.

Short sleeve t-shirts and soft pants are best for all children. Your child may also wear sweatpants, pajamas, or loose fitting 2-piece clothing without “feet” attached

• A small blanket (fleece preferred)
• An extra change of clothes
• Favorite security object from home (stuffed toy, blanket, pacifier)
• Preferred bottle or cup and/or formula, if applicable
• Diapers (if still wearing diapers)
• Wear loose fitting 2-piece clothing or pajamas- no pajamas with feet attached

Storage case for glasses, contact lenses, and/or retainers, if appropriate

Your child will be brought to another room for recovery. This is where you will rejoin your child as he or she awakens from anesthesia. During recovery, your child’s blood pressure and pulse will be checked periodically. When your child is fully awake, he or she will be discharged home. Most patients are able to go home 30 minutes after his or her procedure.

• Have plenty of liquids such as Gatorade, apple juice, and popsicles on hand
• Tylenol or prescribed post-op medications
• First meal should be light, e.g., bread or crackers or soup (avoid fast food)
• Avoid active play for at least 6 hours after procedure
• Normal activities can be resumed by the next day with very little residual effects
• If there is an urgent matter, please call Apex Anesthesia Services at (509) 764-5399 or your dentist’s office.

If there is an emergency, please call 911