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Perioperative approach to children
1Department of Anesthesia and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland.
Insights
Pediatric perioperative care has advanced significantly, emphasizing psychological preparation for children and families. Pediatricians now play a crucial role in this preparation, especially with the rise of outpatient surgeries.
Area of Science:
- Pediatric medicine
- Psychology
- Anesthesiology
Background:
- Significant advancements in pediatric perioperative care have occurred over the last 50 years.
- Recognition of behavioral changes post-anesthesia, surgery, and hospitalization is crucial.
- Parent and physician roles are key in modifying these behavioral outcomes.
Purpose of the Study:
- To highlight the evolution of pediatric perioperative care.
- To emphasize the importance of psychological preparation for children and families.
- To define the pediatrician's role in modern pediatric perioperative care.
Main Methods:
- Review of historical context and contemporary practices in pediatric perioperative care.
- Analysis of the impact of psychological preparation on patient outcomes.
- Assessment of the changing responsibilities of pediatricians in surgical settings.
Main Results:
- Pediatric perioperative care has transformed, focusing on psychological well-being.
- Psychological preparation of the family and child is a critical component.
- The pediatrician's role in preoperative preparation is increasingly vital.
Conclusions:
- Contemporary pediatric perioperative care prioritizes psychological preparation.
- The pediatrician is essential in preparing children and families for surgical procedures.
- The shift towards outpatient and same-day surgery necessitates greater pediatrician involvement.
Abstract:
There has been a tremendous amount of progress in the perioperative approach to the child since Levy wrote "Psychic trauma of operations in children and a note on combat neurosis" nearly 50 years ago. Recognition of prolonged behavioral derangements following the anesthetic-surgical-hospital experience and the prominent role that the parent and physician play in modifying these have dramatically changed the contemporary pediatric perioperative care. Of paramount importance is the psychological preparation of family and child. With increasing outpatient or same-day admission surgery and free-standing surgical centers, preoperative preparation will, of necessity, increasingly become the responsibility of the pediatrician.