General anesthesia is given for surgical repair of curvature of the spine (scoliosis). There are two types of spinal curvature that need surgical correction. The first, sometimes called idiopathic scoliosis, happens when the spine curves abnormally for unknown reasons. The second type of curvature is usually associated with other diseases that affect your child's muscles, nerves and bones.
There are many surgical procedures for children with scoliosis. These include:
Procedures will sometimes take place during a single operation. At other times, orthopaedic surgeons choose to perform more than one surgical procedure on two separate dates. Anesthesiologists' concerns during this type of surgery include:
Your anesthesiologist will meet with you and your child on the day of surgery. Some children with complex medical problems may be required to meet with an anesthesiologist prior to their surgical date.
You will be asked questions about your child's medical history, allergies, current medications, previous anesthetic experience and current health status.
Your child's airway, heart and lungs will be examined carefully. Your anesthesiologist will then discuss with you the anesthetic plan for your child. You will also meet with a member of the pain management team to discuss a strategy to ensure your child is comfortable after surgery.
Sometimes a medication will be given either by mouth or intravenously (IV) before surgery to help your child relax before coming to the operating room. This medication also provides amnesia, so your child does not remember the stress of getting ready for surgery.
Anesthesia is started with IV medication or, in younger children, by giving gas through an anesthesia mask. Once your child is asleep, a breathing tube and additional intravenous (IV) lines are placed.
A variety of monitors check the heart's electrical activity, oxygen levels in the blood and breathing.
Because it is important to carefully monitor blood pressure during your child's spine surgery, a special blood pressure monitor (an arterial line) is placed after your child goes to sleep.
An arterial line is like a regular IV, but it is placed in an artery rather than a vein (usually in the wrist). This allows the care team to carefully monitor your child's blood pressure and to draw blood samples for lab tests.
The arterial line will stay in place for a while after surgery.
The medications given during surgery help your child go into deep sleep, provide excellent pain relief and relax the muscles during surgery.
Many anesthetic medicines are used for spinal surgery, including anesthetic gases and intravenous drugs. Your anesthesiologist will choose the best type of anesthetic based on your child's needs.
These medications are also designed to avoid interfering with spinal cord and nerve function monitoring that may happen during your child's surgery. This special monitoring is known as neurophysiologic monitoring.
Neurophysiologic monitoring involves placing special monitoring electrodes on the patient, usually after they are asleep. While your child is asleep, the neurophysiologist constantly monitors several nervous system functions so that potential problems are immediately recognized.
When neurophysiologic monitoring is used, the anesthesiologist will work with the neurophysiologist and surgeon to provide an anesthetic that does not significantly interfere with monitoring, but keeps your child safe and comfortable.
The anesthesiologist, surgeon and neurophysiologist are in constant communication to help ensure that potential problems are identified immediately and the appropriate action is taken.
As part of the monitoring of nerve function, a "wake up" test may be performed. In this test, the anesthetic is lightened to see if your child is able to move their feet in response to a verbal command. This test typically takes less than five minutes.
The anesthetic is then deepened until your child wakes up after the surgery is completed. The wake up test is not uncomfortable for your child and they usually do not remember it after surgery.
It is not uncommon for children to need blood transfusions during spinal surgery. This is particularly true if your child has nerve or muscle disease that has resulted in curvature of the spine.
Some children will have the opportunity to donate their own blood to the blood bank before their surgical procedure. This blood will then be given back to the child as needed in the operating room.
At other times, this type of self-directed blood transfusion will not be possible. Your anesthesiologist will monitor your child carefully to determine when a blood transfusion is needed.
While every effort is made to minimize the use of blood transfusion in the operating room, your child's health and well-being is the top priority.
After surgery, some children are awakened immediately in the operating room when the surgery is finished. Others must be kept asleep after surgery, usually no more than one to two days.
Under these circumstances, children will remain deeply asleep with their breathing tube in place, and will need a ventilator.
If your child is still sleeping or a decision has been made by the orthopaedic surgeon to admit your child to the Pediatric Intensive Care Unit / PICU, your child will be transferred directly from the operating room to PICU for careful monitoring.
When your child is awakened and meets the criteria, they will be transferred to the post anesthesia recovery room (PACU) and eventually to their assigned room. While in PACU, your child’s care will be directed by an anesthesiologist, an orthopaedic surgeon and PACU nurses. When your child is transferred to their inpatient room, their care will be directed by the orthopaedic surgeon and assigned nurses.
We administer medications and operate specialized equipment to provide anesthesia, pain management, organ protection and life support services for surgery, radiology and other medical situations.
Last Updated 12/2025
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