Pediatric: Preoperative anxiety
Who is at greatest risk?
Why treat it?
5 factors that provoke anxiety:
Pharmacologic Management -Route given : oral > nasal> IM > rectal Medication % usage/ route options & dose:
PO (0.5 mg/kg), nasal/sublingual (0.2–0.3 mg/kg), rectal (0.5-1 mg/kg)
PO (5-6 mg/kg), IM (2-5 mg/kg), nasal(3-5 mg/kg), rectal (5-6 mg/kg)
PO (10–15 mcg/kg), IV (2 mcg/kg)
Nasal (3 mcg/kg), IV (0.5-1 mcg/kg)
Clonidine (?) PO (4-6 mcg/kg)
Non-Pharmacologic Management Parental presence
- Pros: Avoids the need for pre-operative sedatives, avoid separation anxiety
- Cons: Adverse parental reaction and litigation if injury ensues, anxious parents, stress on anesthesiologist/OR staff, less effective than Midazolam
Work with children pre-op to reduce incidence of anxiety
Give parents and children an idea of what to expect on the day of surgery and reduce anxiety