Abstract
Children are anxious before anesthesia, and studies show up to 25% may require restraint. Anxiety at induction has many consequences including regression in behavior (or dysfunctional behavior) that may last months, increased pain, and fear of future hospitalization and anesthesia. Pharmacological premedication is the single most effective method of reducing anxiety, and one can be selected from a range of agents according to the level of the child’s anxiety. The behavior of the anesthetist also has a large effect on a child’s anxiety at induction. Some behaviors of the anesthetist and other health care providers focus the child on their anxiety, whereas others distract and calm the child. There are simple and practical methods to distract children at induction or during procedures. Although parental presence in theater does not reduce the child’s anxiety at the moment of induction, it avoids separation, involves the parent and should be included as part of family centered care.
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Child Development and Preparation
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Premedication and Induction
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Hypnosis
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Restraint
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1.
What factors are associated with increased anxiety in children at induction?
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2.
An 11 year old girl has been brought to the induction room before a hernia repair under GA. She keeps her arms folded and refuses to put out her hand for an IV. What will you do?
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3.
The mother of a 5 year old boy who has had multiple GA’s and appears frightened requests a premed for her son. What premed would you use, and why?
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Sims, C., Khoo, L. (2020). Behavioral Management of Children. In: Sims, C., Weber, D., Johnson, C. (eds) A Guide to Pediatric Anesthesia. Springer, Cham. https://doi.org/10.1007/978-3-030-19246-4_3
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DOI: https://doi.org/10.1007/978-3-030-19246-4_3
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