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Sterling Ridge Orthopaedics & Sports Medicine
6767 Lake Woodlands Drive, Suite F, The Woodlands, TX 77382
20639 Kuykendahl Road, Suite 200, Spring, TX 77379
The Woodlands & Spring, TX .
Ph: 281-364-1122 832-698-011
stacy@srosm.com






Ankle
Child Orthopedics
Elbow
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Fractures
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Pain Management
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Spine - Cervical
Spine - General
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I just finished reading a handout given to us by the surgery center where our 12-year-old daughter is going to have spine surgery for her scoliosis. My head is spinning. How are we supposed to know what kind of anesthesia and medications for pain she needs? Here's a list of all the things they say there are to choose from: nonopioid analgesia, opioid analgesia, local anesthetic injection, regional anesthesia, epidural therapy, peripheral nerve blocks, and much more. Please help!

It is not likely that as parents you will be the ones to decide what anesthesia and post-op medications your daughter will need. Most surgical teams and postoperative hospital staff take the task of pain control among children very seriously. They may even have a team dedicated to this job. The first step is family and patient education. The handout you were given was evidently part of their effort to give you information to explain what will happen and why. Everyone involved with the child's case must understand the importance of pain control and the consequences of inadequate pain management. The surgeon, anesthesiologist, and nursing staff help parents, family members, and care givers of children understand how the pediatric body responds to pain. From the youngest baby to the oldest child, decisions about medications for pain control are based on several individual factors. Body weight is important because the water content affects how drugs bind with proteins in the blood. Age and size determine the water-to- protein ratio and thus the amount of drug to use (e.g., anesthesia during surgery, narcotics for pain control after surgery). There are strict guidelines for the use of pain relievers. One important factor that affects the physician's selection of medications is the child's health. For example, the presence of any other health conditions (e.g., asthma, diabetes, allergies, bleeding disorders) must be considered carefully. The type of orthopedic surgery, extent of the surgery, and length of the procedure (in time) can also make a difference in postoperative selection of pain medications. The anesthesiologist can choose from a wide variety of drugs for the actual procedure including all of the ones you listed: nonopioid (nonnarcotic) pain relievers, opioid analgesics (narcotic pain relievers), local anesthetic injection, regional analgesia, epidural therapy, and peripheral nerve blocks. Likewise, the surgeon has quite a few choices for pain control after the surgery. It's clear that pain is different from one child to another even when they have the same surgery for the same problem. That's why each child is evaluated and monitored separately from all other children. It's not a one-protocol-fits-all kind of situation. With this handout available, you will be better able to understand when the anesthesiologist tells you which type of anesthesia is going to be used. You may receive some additional written explanations the day of the procedure and even afterwards. It sounds like your daughter's surgical team is making an effort to provide you with helpful information. Be sure and ask any questions you may have as information is given to you that you don't understand fully.

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