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Distress at induction: prevention and consequences

Andrew Davidson1, Ian McKenzie

  • 1Department of Anaesthesia, Royal Children's Hospital, Parkville, Australia. andrew.davidson@rch.org.au

Current Opinion in Anaesthesiology
|April 16, 2011
PubMed

Insights

Reducing preoperative distress in children is crucial. While non-pharmacological methods offer modest benefits, sedative premedication, particularly alpha-2 adrenergic agonists, shows greater effectiveness in managing perioperative anxiety.

Area of Science:

  • Pediatric Anesthesiology
  • Child Psychology
  • Healthcare Quality Improvement

Background:

  • Hospitalization and surgical procedures induce significant distress in children.
  • Perioperative anxiety is a major concern, impacting immediate behavior and long-term outcomes.
  • Minimizing distress is increasingly recognized as a preventable and essential aspect of pediatric care.

Purpose of the Study:

  • To review recent research on reducing preoperative distress in children.
  • To evaluate the impact of interventions on behavior during anesthesia induction and long-term postoperative outcomes.
  • To highlight the importance of assessing and minimizing non-pain-related distress.

Main Methods:

  • Review of recent research on pediatric perioperative anxiety and distress.
  • Assessment of new measures for evaluating anxiety in children.
  • Analysis of the efficacy of pharmacological and non-pharmacological interventions.

Main Results:

  • New anxiety assessment tools improve intervention efficacy evaluation.
  • Non-pharmacological interventions provide modest anxiety reduction; sedative premedication is more effective.
  • Alpha-2 adrenergic agonists like clonidine and dexmedetomidine offer sedation but have slow onset times.

Conclusions:

  • Improved anxiety measures will enhance clinical evaluation and future research.
  • The precise role of alpha-2 adrenergic agonists in premedication requires further clarification.
  • More research is needed on distress minimization techniques tailored to individual children and families.
Abstract

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