Foundations of Pediatric Anesthesia

Abstract

Psychological preparation of the child for surgery should be tailored to the developmental stage of the child, guided in part by the child’s age, and whether the child will be admitted to hospital after surgery or go home. Prehospital preparation for school-age children may include web-based strategies, videotapes, or a tour of the operating room. Younger children may benefit from a storybook or coloring book. Separation from the parents can be traumatic; anxiolysis should be addressed using distraction techniques including puppets, electronic games, and videos for the child, having the parents present at the induction or premedication, most commonly in the form of oral midazolam. Children with neurocognitive disorders present unique challenges, requiring parental presence and/or premedication for anxiolysis. Obtaining consent presents special concerns for the vulnerable child that requires a focused preoperative interview. Postoperative care should aim to reunite the parents with the child when the child is awake.