The Surgery Center

Most of Dr. Lewin’s patients will have surgery at Cove Surgery Center focused on pediatric patients. For a variety of reasons, some patients may also be treated at Cedars Sinai Medical Center.

At Cove Surgery Center, a pediatric anesthesiologist will provide your child’s anesthesia and pediatric nurses will care them for. Parents are offered the opportunity to be present when their child goes to sleep (anesthesia induction) for their procedure.

Before Surgery

Dr.. Lewin’s office will contact you well before your surgical date to go over any questions you may have about surgery. A detailed packet will be sent to you that will outline an overview of the surgery including all of your appointments, all pertinent addresses and phone numbers, as well as preoperative and postoperative instructions.

You will receive a preoperative call from a nurse before your child’s surgery. During this call, you will be told when to arrive at Cove Surgery Center, and what items you should bring with you. The nurse will answer any questions you may have. The pre-operative fasting instructions for your child will also be explained. If your child is sick, please let the nurse know during the phone call.

Pre-operative fasting instructions for Cove Surgery Center are as follows:

Patients younger than 16 years of age may:

Drink clear fluids up to 2 hours vor arrival: Apple juice or water only.
Drink regular milk up to 6 hours vor Chirurgie.
Eat solid foods up to 8 hours before Chirurgie.

Patients older than 16 years old may:

Have no solid food 8 hours vor Chirurgie.
Drink clear fluids up to 4 hours vor Chirurgie.

Additional instructions:

  • Please notify Dr. Lewin if there are any signs of illness up to 3 weeks before the date of surgery, such as fever, sore throat, cough, runny nose, wheezing, rash or abrasion in the area of surgery site.
  • Patients should shower or bathe the night before surgery.
  • Your may brush his/her teeth on the morning of surgery but do not let them swallow any of this water.
  • No candy or chewing gum on day of surgery.
  • Medication may be taken on the morning of surgery with a sip of water.
  • If your child wears glasses or a hearing aid, please bring a case to store it in during surgery
  • Have the child wear casual, loose fitting clothing.
  • Bring a favorite quiet toy or two and/or special blanket if they have one, and a light special snack if they have a strong preference in food for after surgery.

A legal guardian will be required to remain at the Surgery Center throughout the surgery.

The Day of Surgery

Give yourself plenty of time to get to K and B Surgical Center, park your car, and get registered at the front desk. Our receptionist will review the registration information with you. You and your child will stay in the waiting lounge until your nurse meets you and brings you back to the preoperative holding area. There, your nurse will conduct a brief examination, including taking your child’s temperature, and measuring height and weight. Your child will be given a gown to change into. You will meet your anesthesiologist at this time. Your anesthesiologist will ask you about your child’s medical condition, and discuss with you the anesthesia plan, including the risks and benefits of anesthesia. Be sure to ask any questions you have. Before going to the operating room, your surgeon will meet you, examine your child, and answer any questions you may still have about the surgery.

It is normal for your child to feel scared or anxious on the day of surgery – not only by the thought of the procedure itself, but also by the unfamiliar surroundings, faces and sounds. A sedative will often be prescribed by your anesthesiologist to allay your child’s anxiety. Young children will be given this sedative to take by mouth in the form of a flavored liquid. Older children and adults will have an intravenous (“IV”) line placed in the preoperative holding area, and can receive an injectable medication to help with anxiety. In most cases, a parent will be allowed to accompany the child into the operating room and stay until the child falls asleep. After your child falls asleep from the anesthesia, you will be asked to wait in the waiting lounge. There, you will receive regular updates on the progress of the surgery or procedure. Make sure the staff has your cell phone number if you do leave the surgery center for any reason.

Anesthesia

The most common type of anesthesia for children having surgery is general anesthesia. General anesthesia is a special kind of sleep brought about by anesthetic medications. When asleep, your child will experience no awareness or pain. Young children are often afraid of needles, so your anesthesiologist will most likely give general anesthesia as a gas that your child will breath through a plastic mask. Anesthesia can also be given as medications through an intravenous (“IV”) line, and this is the usual technique for older children and adults. During general anesthesia, your anesthesiologist’s most important responsibility is to monitor your child and keep him/her safe, asleep, and comfortable during the procedure. After the surgery is over, your anesthesiologist will wake your child up.

In addition to general anesthesia, your anesthesiologist may recommend other anesthetic medications and techniques to help improve for your child’s comfort and pain management. These include the injection of local anesthetic medications (“numbing medicine”) around the surgical site, or around the nerves that transmit pain sensation in the part of the body having surgery.

After Surgery

After Surgery, parents will be allowed to quickly re-join their children in the recovery room. Your child will be taken care of by a recovery room nurse who is experienced in pediatrics. Your nurse will assess your child’s vital signs, breathing, as well as be alert for any problems arising from the procedure or anesthesia. It is normal for children waking up from general anesthesia to feel drowsy and disoriented. Don’t worry, these symptoms will improve during the recovery room period, and continue to resolve during the first 24 hours after surgery. If your child experiences significant pain or nausea in the recovery room, your nurse will take immediate steps to treat it. Once your child is sufficiently awake, he/she will be offered something to drink. After your child has met discharge criteria and is sufficiently recovered from anesthesia, you may take your child home.

  • Do not give your child a lot to eat or drink before and during the car ride back home. Motion sickness can aggravate post-operative nausea.
  • Your child may resume their normal diet if they are not nauseous, but it is best to go slow.
  • Please keep your child from being too active after surgery, normal activity is fine, but rough playing should be avoided.
  • Expect that your child will be less energetic and less hungry in the first 3 days after surgery.
  • Dr.. Lewin’s cell phone is 310-291-2078. If you have any questions after surgery, please call her … that is why she gives her personal number to every patient!

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