Preparation for General Anesthesia in Children

Rosy Kim, St Barnabas Health System, Robert Karpinos, Maroje Turk
2019 Anesthesia & Clinical care  
Midazolam has been a "gold standard" method of preoperative anxiolysis. Midazolam is a short acting benzodiazepine that is very lipophilic in physiological pH, which explains its properties in the rapid onset of action. Other than its quick onset of action, midazolam carries many other benefits such as minimal respiratory depression, Abstract Children and parents experience significant anxiety and stress prior to surgery. Many endeavours were made by anesthesiologists to reduce anxiety during
more » ... eoperative and pre-induction periods. Various techniques were used to minimize induction time because prolonging the time of induction leads to negative psychological effect during postoperative period such as nightmares, eating disturbances, apathy and withdrawal, enuresis, and separation anxiety. In the preoperative period there are 'stress points' when the anxiety reaches the maximum in pediatric patients. The stress points include separation from the parents, entry to operating room, placement of child on the operating table, visualization of syringes, attachment of monitors, placement of intravenous cannula, and placement of mask, etc. The aim of anesthesiologists should be to reduce these stress points as much as possible until the patient transitions into an anesthetized phase. This review article will cover various anxiolysis preinduction techniques from a traditional pharmacological intervention, moving to a parental intervention, and the most up to date distraction technique using electronic devices. By incorporating a traditional and a new pre-induction practice, anesthesia providers can develop their own set of pre-induction technique to prepare children for general anesthesia.
doi:10.24966/acc-8879/100040 fatcat:dwaj5o6jvvekxb7yuygshgrdti