Types of Pediatric Anesthesia

There are three main categories of anesthesia:

• general
• regional
• local

In pediatric anesthesia, almost all surgery performed in the operating room is done with general anesthesia.

General anesthesia minimizes anxiety for both patient and parents. A parent is almost always allowed to accompany the child into the operating room. In younger children, general anesthesia is usually induced (started) by inhaling anesthetic gases through a mask. This process may provoke anxiety in the child, but it is clearly much less traumatic than injections or intravenous catheters (IVs). If an intravenous is required for the surgery, it can then be placed after the child is under anesthesia (asleep).

In older children, the parents and child have a choice: mask induction (see above) or intravenous induction. For intravenous (IV) induction, EMLA cream (a topical local anesthetic) can be applied on arrival to the hospital; this further minimizes pain by numbing one or more areas where an IV might be placed.

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Regional anesthesia refers to spinal, epidural, or nerve block anesthesia. Because needles are used for each of these anesthetic types (in addition to an intravenous catheter placed prior to the anesthesia), regional anesthesia is almost never used in children under the age of sixteen.

Exceptions do exist, of course, but in these instances, the anesthesiologist has an important medical justification for suggesting regional anesthesia.

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Local anesthesia refers to anesthetic medication ("Novocain") that is injected into the part of the body requiring minor surgery, for example, removal of a cyst on the back, hand, or foot. In pediatric anesthesia, local anesthesia is often combined with general anesthesia to minimize pain postoperatively, but it is rarely used as the sole anesthetic.

For further questions regarding types of anesthesia, see the FAQ page.

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