Global Perspectives on Obstetric Anesthesia: Challenges and Priorities for Advancing Maternal Health

This patient is at significant risk for preoperative anxiety. There is a 60% incidence of preoperative anxiety. Children who are at highest risk for anxiety include those with the following characteristics: age older than 7 years, shy or introverted personality, the presence of anxious parents, no siblings, previous upsetting hospital experience, and those who did not attend preschool. It is important to treat preoperative anxiety since anxiety can delay induction of anesthesia, prolong recovery from anesthesia, and be associated with behavior problems for up to 1 year following anesthesia. Options for treating preoperative anxiety include nonpharmacological therapies, such as parental presence at induction or video games, and pharmacological therapies. Medications used to treat preoperative anxiety in children include midazolam, ketamine, fentanyl, dexmedetomidine, and clonidine.