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Minimizing Distress in Children Before Surgery

More than 3 million children in the United States have major surgery every year, and these procedures often require them to undergo general anesthesia. The prospect of surgery is stressful regardless of the patient’s age, but doctors need to be particularly sensitive when patients are children. The entire surgical team should work closely together and with the child’s parents to minimize the stress and trauma that they may face before and after surgery. The preoperative process is particularly critical. Much of the anxiety and trauma children experience after surgery is because of the procedures we put them through prior to their operation, from giving them shots to putting masks on their faces to deliver the anesthetics. It’s estimated that 50% of children who have major surgery suffer some sort of postoperative behavioral changes after their operation, including night terrors and other longer-lasting emotional issues. Make Efforts to Minimize Impact Doctors can take simple steps toward minimizing the emotional distress that children face before and after surgery: 1. Spend time with parents before the surgery. Explain precisely what will happen and when it will happen. Include details on when and how anesthesia will be administered, and how it could affect their child’s behavior after the operation. Many children experience “emergence delirium,” where they are thrashing, crying, and inconsolable, which can be terrifying for parents. To circumvent this, describe details on expectations to alleviate postoperative stress. Also ensure that parents are active participants preoperatively. 2. Minimize trauma from needles and anesthesia masks. If possible, give children oral midazolam about 30 minutes prior to surgery so that they are comfortable and relaxed...
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