Canadian Journal of Anaesthesia

, Volume 41, Issue 11, pp 1094–1103 | Cite as

Preparing children for the operating room: psychological issues

  • Terry McGraw
Review Articles

Abstract

Children respond psychologically to the prospect of surgery in a variable and age-dependent manner. This review summarizes the psychoanalytic, cognitive, behavioural and family system models of child development. It then reviews studies of hospitalization and anaesthesia in children. These studies suggest that younger children, children previously anaesthetized, and children who experience turbulent anaesthetic inductions are at particular risk for postoperative behavioural disturbances. Strategies of dealing with children and their parents during the perioperative period are discussed. Such strategies include: allowing a parent to be present during induction of anaesthesia, administering sedative premedication, creating a supportive environment, educating children and parents (verbal descriptions, tours, books, videos), and establishing rapport with children and their parents. Age-specific techniques of establishing rapport with children are discussed. If children are less anxious during the perioperative period, not only will they often exhibit less behavioural disturbances postoperatively, but they may face subsequent medical care more easily.

Key words

anaesthesia: paediatric psychological responses surgery: paediatric 

Résumé

Chez l’enfant, la répercussion psychologique de la chirurgie est variable et influencée par l’âge. Ce survol rappelle en résumé les aspects psychanalytiques, cognitifs et comportementaux propres au développement infantile. Par la suite, il étudie les effets de l’hospitalisation et de l’anesthésie des enfants. Ces études suggèrent que les enfants plus jeunes, anesthésiés auparavant ou ayant subi des inductions agitées sont particulièrement sujets à des troubles du comportement après une intervention. Pour ces enfants et leurs parents, des stratégies permettant de faire face à l’intervention sont discutées. Elles comprennent: la présence d’un parent à l’induction, l’administration de sédatifs en prémédication, la mise en place d’un climat favorable, l’éducation (descriptions, visites, dépliants, vidéos), et des prises de contact tant avec les enfants qu’avec leurs parents. Des techniques de rapprochement appropriées à l’âge sont discutées. En soulageant l’anxiété des enfants à la période préopératoire, non seulement on améliore leur comportement postopértoire, mais on leur permet d’affronter plus facilement la suite des événements médicaux.

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Copyright information

© Canadian Anesthesiologists 1994

Authors and Affiliations

  • Terry McGraw
    • 1
  1. 1.Department of AnesthesiologyUHS-2, Oregon Health Sciences UniversityPortland

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