Behavioral Management of Children

  • Craig SimsEmail author
  • Lisa Khoo


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.


Perioperative anxiety Anesthetist behaviors and child anxiety Distraction techniques for anesthesia induction Parental presence at induction Premedication for pediatric anesthesia 

Further Reading

Child Development and Preparation

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Premedication and Induction

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  1. Kuttner L. Pediatric hypnosis: pre-, peri, and post-anesthesia. Pediatr Anesth. 2012;22:573–7. A review article giving an introduction to hypnosis, including the ‘magic glove’ technique for IV insertion.CrossRefGoogle Scholar
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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of Anaesthesia and Pain ManagementPerth Children’s HospitalNedlandsAustralia

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