Preparing Your Pediatric Patients and Their Families for the Operating Room: Reducing Fear of the Unknown.

Adam C. Adler, MS, MD*,‡2. Stephanie Leung, BS, CCLS†3. Benjamin H. Lee, MD*,‡4. Scott R. Dubow, MD§ 1. *Department of Anesthesiology, Perioperative and Pain Medicine and2. †Department of Child Life, Texas Children’s Hospital, Houston, TX3. ‡Baylor College of Medicine, Houston, TX4. §Department of Anesthesiology and Critical Care Medicine, The Children’s Hospital of Philadelphia; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA* Abbreviations: BiPAP: : bilevel positive airway pressure CLS: : child life CPAP: : continuous positive airway pressure DEA: : Drug Enforcement Administration IV: : intravenous MRI: : magnetic resonance imaging OSA: : obstructive sleep apneaClinicians should: identify the resources available to patients and families to allow for a smooth perioperative experience; understand the long-term effects and potential maladaptive changes associated with an anxiety-provoking perioperative period; understand the most common parental and patient concerns and misconceptions regarding surgery; understand the most common and up-to-date perioperative anesthesia practices; understand the indication for referral to the preoperative anesthesia clinic for patient evaluation to avoid unnecessary cancellation.Pediatricians are often tasked with preparing children and their families for the preoperative period and dealing with questions related to postoperative issues and concerns. Instruction based on current practice and new research and techniques may help patients and families cope with the stressors of surgery. Determining which patients may benefit from a medical or child life preoperative visit is of crucial importance.After completing this article, the reader should be able to:1. Describe common preoperative anesthesia practice.2. Recognize the role of a child life specialist in preparing children for surgery.3. Differentiate children who would benefit from a preoperative anesthesia and/or child life evaluation.4. Instruct patients and families on issues related to the perioperative period.5. Address a wide array of parental concerns regarding surgery, anesthesia, and postoperative pain management.The period of time surrounding a planned surgical procedure can be tumultuous and anxiety provoking for both pediatric patients and their parents. The “mysterious place” that is the operating room often remains a mystery to many health care providers, including those tasked with caring for patients both before and after a procedure. As the health care provider most familiar to patients and their families, the pediatrician is in a …