Anesthesiology
Our Expertise
The differences between the anatomy of adults and children make it imperative for the medical team to have a specialized knowledge and understanding of those differences. Children have more soft tissue than adults, as well as a greater blood flow to the brain and heart. In addition, the enzymes and receptors that interact with some drugs may not be fully mature in a child, so their drug metabolism is not the same as that of an adult. All items used in care, such as IVs and central lines, although similar to those used in adults, are smaller and sized for the child. Our pediatric anesthesiologists receive specialized training in order to treat these young patients with the highest quality of care and safety.
Each pediatric anesthesiologist is an integral part of the patient care team not only during surgery, but also in the pre- and post-surgical settings. Before each procedure, the pediatric anesthesiologist consults with pediatricians, surgeons and other sub-specialists to formulate a plan of care. As part of the preparation, the team--which includes a pediatric nurse practitioner who specializes in anesthesiology--performs a thorough evaluation and physical examination of the child and discusses the pertinent issues and anesthesia plans with the family in view of the special needs their child might have.
Specific areas of our expertise include:Pediatric Pain Management
The Pediatric Pain Management Service at NewYork-Presbyterian Morgan Stanley Children's Hospital, the first dedicated pediatric pain management center to be established in New York City more than 10 years ago, provides highly specialized pain treatment and symptom management for children of all ages from birth through adolescence. The Pain Management Service is committed to providing pain control using multiple types of therapies that are age and dose appropriate, always with the safety and well being of our patients foremost in mind.
Among the first of its kind, our inpatient pediatric pain medicine program cares for children who have had surgery with the most current methods such as patient-controlled analgesia (PCA), patient-controlled epidural analgesia (PCEA), regional nerve blocks and perineural catheters. Following surgery, our Pain Management staff meets with the patient and family in the PACU (Post Acute Care Unit) and then sees them the next morning after surgery to assess pain management needs and determine when it might be appropriate to move to oral analgesics.
Through the Herbert Irving Pediatric Outpatient Center, we also treat patients who have chronic pain due to medical illnesses such as leukemia, lymphoma, solid tumors, sickle cell disease and HIV/AIDS, as well as children with neurological, digestive, and autoimmune disorders. We treat the discomfort associated with therapies such as bone marrow and solid organ transplantation, as well as the discomfort of minimally invasive surgical procedures. In addition, we provide relief for pain syndromes resulting from nerve dysfunction such as chronic regional pain syndrome.
Our team also consults with psychologists, physical therapists, Child Life specialists, and other disciplines as necessary to treat the individual's pain syndrome.
Recognizing Pain in Infants and ChildrenThe processing of pain varies with developmental differences between the neonate, the premature baby, a newborn, infant, toddler, child and adolescent. Our physicians and nursing team are specially trained to monitor and assess pain at different ages, and respond with appropriate and safe treatment.
While older children are better able to express their level of pain, either through a rating scale of 0 to 10, with 0 meaning no pain, infants and most toddlers cannot communicate verbally. In infants and in pre-verbal children or children who are cognitively impaired, our physicians and staff recognize the characteristic appearance of pain, For example, infants in pain exhibit very specific displays of discomfort through their facial expressions and the type and intensity of their crying. Through a "faces scale," toddlers are asked to draw pictures that can help to demonstrate their degree of pain--mild, moderate or intense.
The Pediatric Pain Management Service also treats children who experience distressing symptoms such as nausea, vomiting, itching, insomnia, and fatigue that can result from chronic illness or chemotherapy.
Palliative Medicine ProgramThe Pediatric Pain Management Service also has in place a palliative medicine program to assist children at end of life, as well as those who have chronic life-threatening illnesses. Palliative care is viewed as a continuum of care. It begins at the time of diagnosis of a potentially life-threatening condition and extends through treatment. Our staff-always compassionate and sensitive to the needs of our patients and families-help parents cope with decision-making issues and to understand the process of their child's disease. We do all that is possible to alleviate any pain or discomfort as a consequence of the disease or therapy.
Pediatric Cardiovascular AnesthesiaThe Anesthesiology Department also offers special expertise in pediatric cardiovascular anesthesia. Hundreds of children who undergo heart surgeries, cardiac catheterization procedures and electrophysiology studies at Morgan Stanley Children's Hospital each year are carefully monitored by a cardiovascular anesthesiology team that specializes in heart disease. The most complex cases are routinely and successfully cared for by our skilled and experienced surgeons, cardiologists, and anesthesiologists working closely together.
Prior to most surgeries, the child is given a sedative orally or through an intravenous line to relax him or her. The anesthesiologist then administers anesthetics to ensure the child is asleep with no awareness during surgery, while careful monitoring all of the child's vital functions, including blood pressure, temperature, heart function and oxygen levels in the blood.
The anesthesiologist monitors the child from the pre-operative evaluation through surgery and until the child is stabilized in the intensive care unit following the operation, where he or she is then transferred to the care of the highly skilled ICU and recovery team.
TransplantThe Anesthesiology Division also has dedicated anesthesia transplant teams who have specific expertise in heart, liver, kidney, and small bowel transplantation. These complex and often lengthy operations require special knowledge to manage fluid shifts and blood loss, particularly as they can affect young patients. Overseeing a high volume of cases, our transplantation teams are prepared for any complication.
Fast Track Recovery RoomThe Department of Pediatric Anesthesiology in collaboration with the PACU (Post Anesthesia Care Unit) has instituted a Fast Track Recovery Room (Phase 2 Recovery Room) to facilitate a faster discharge for selected patients who have had minimally invasive and minor procedures. The anesthesiologist determines if the patient, who must be older than one year, can go directly to the Fast Track Recovery Room, which is only available during daytime hours. These patients are awake and alert in a short period of time; are in no danger of respiratory compromise; do not require pain medications; are well hydrated; have had minimal blood loss; and have undergone a minimally invasive procedure.
Contact
- Pediatric Anesthesiology
- (212) 305-2413
