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Preoperative evaluation, premedication, and induction of anesthesia in infants and children

Suzanne Strom1

  • 1Department of Anesthesiology and Perioperative Care, University of California, Irvine, Orange, California 92868, USA. sstrom@uci.edu

Current Opinion in Anaesthesiology
|April 11, 2012
PubMed

Insights

Nonpharmacologic methods effectively reduce pediatric perioperative anxiety, similar to sedative medications. Further research is needed to compare specific premedications and nonpharmacologic interventions for optimal outcomes.

Area of Science:

  • Pediatric Anesthesiology
  • Perioperative Medicine
  • Evidence-Based Practice

Background:

  • Anesthesia preparation and induction in children have seen significant advancements.
  • Focus on reducing perioperative anxiety using nonpharmacologic and pharmacologic strategies.

Purpose of the Study:

  • To review current techniques for reducing anxiety in pediatric anesthesia.
  • To analyze recent large population studies and meta-analyses on these techniques.

Main Methods:

  • Review of recent large population studies and meta-analyses.
  • Evaluation of nonpharmacologic and pharmacologic anxiety reduction methods.

Main Results:

  • Nonpharmacologic methods show effectiveness comparable to sedative premedications, except for parent-present induction.
  • Healthcare providers can be trained to enhance anxiety-reducing behaviors.
  • Clonidine and dexmedetomidine demonstrate qualities similar to or better than midazolam.

Conclusions:

  • Further large-scale studies are required for nonpharmacologic interventions like parental acupuncture.
  • More research is needed on specific outcomes (onset, emergence, discharge, postoperative nausea/vomiting, delirium) to differentiate sedative premedications.
Abstract

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