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While some people tend to think of children as miniature versions of ourselves, children aren't just little adults. This is certainly true when it comes to anesthesia. The growing body of research shows that children react to medications differently. For this and other reasons, anesthesia must be tailored to the pediatric population to ensure safe and successful surgery.

There are differences between adult's and children's anatomy that make it imperative for the medical team to have a specialized knowledge of those differences, says Lena Sun, M.D., division chief of pediatric anesthesiology at Children's Hospital of NewYork-Presbyterian (CHONY) and associate professor of anesthesiology and pediatrics at Columbia University College of Physicians & Surgeons. For example, 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 isn't the same as adults. Pediatric anesthesiologists receive specialized training in order to treat these young patients appropriately. Pediatric patients need pediatric anesthesiologists, she emphasizes.

Each CHONY pediatric anesthesiologist is an integral part of the patient care team not only during surgery, but in the pre- and post-surgical settings as well. Before each procedure, the pediatric anesthesiologist works with pediatricians, surgeons, and other subspecialists to formulate a plan of care. As part of the preparation, the team 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 children have regarding anesthesia. Parents accompany their child into the operating room and stay until the child falls asleep from anesthesia. Parents are also allowed in the recovery area before the patient emerges from anesthesia. This way the parent is the last vision the child has before falling asleep and the first vision they see when waking up after surgery. These transitions provide a more secure and less anxiety-provoking experience for the child.

We know that no child or parent looks forward to going to the hospital, especially if it's for surgery. But we can make it easier for children and their families. And that means having a heightened awareness of their special needs especially in the all too often overlooked setting of pediatric anesthesia and having a well-trained team ready and able to respond to those needs not only during surgery but before and after as well, concludes Dr. Sun.