Although many adult ocular procedures may be done equally well under local or general anesthesia, with children, the anesthesiologist almost always has to administer general anesthesia to guarantee satisfactory surgical conditions. 2. Patient preparation includes parental understanding of the procedure, the anesthetic and its implications, and the care of the postoperative child. In general, anesthetic induction is accomplished in an age-appropriate fashion. 3. Basic discharge criteria include the following: Vital signs should be stable and normal; there should be no signs of respiratory distress; mental status should be age-appropriate and back to baseline; the patient should demonstrate the ability to either swallow fluids, cough, or have an intact gag reflex; the patient should be able to ambulate, if age-appropriate and baseline; and the patient always must have a responsible, well-informed escort home.
