Over the past 3 years, 683 Pediatric open heart cases and 1510 pediatric cases underwent surgery at AUBMC requiring anesthesia. Pediatric anesthesia is not merely adjusting doses to smaller body weights. It entails an adapted global approach that starts the moment children or parents learn about the impeding intervention and extends until the convalescent child is ready to leave the hospital. It is a dynamic department, whereby teaching is a priority, encompassing didactic teaching and “hands-on” training. With the high volume at AUBMC, practice does make perfect. Residents rotate for a minimum of two months in the Pediatric Anesthesia Rotation during their residency period whereby all goals and objectives are concentrated on patient care, medical knowledge, communication and interpersonal skills, professionalism, problem based learning and improvement, and system based practice.
Preparing children for their operating room experience is of paramount importance. An anesthesiologist is always available for the preoperative evaluation and psychological preparation of the child in the preadmission unit of the hospital or on the ward the day before surgery. On the day of surgery, all children scheduled will transit through a holding area before they reach the operating room. They will be received in a child-friendly environment accompanied by their parents. A final assessment will be done and premedication will be administered to relieve separation anxiety. During induction, maintenance and recovery from anesthesia children are continuously monitored in compliance with the American Society of Anesthesiologists standards. Following emergence from anesthesia, children are admitted to the post anesthesia care unit (no parent is allowed to remain with the child during the whole length of stay to decrease the anxiety related to his presence in a hostile environment). Considered as the fifth vital sign, pain is assessed frequently and its treatment is carefully tailored to ensure comfort, safety, and smooth recovery. Following discharge from the PACU, the anesthesia-based acute pain service of the hospital continues to be involved in the treatment of postoperative pain on the ward.
Caring for the surgical child and his family is a team effort which requires that the nurses, surgeons, pediatrician and anesthesiologists are all involved. In a joined effort with all health care providers, the aim of the anesthesiology department at AUBMC is to provide a high quality care to pediatric patients and offer them a stress-free hospital experience.
Roland Kaddoum, MDPediatric Anesthesia Division Director