Which of the following measures has been shown to be MOST EFFECTIVE in decreasing preoperative anxiety in the pediatric population?
a) Parental presence during induction of anesthesia
b) Premedication with midazolam
c) Behavioral preparation including OR tours
d) Distraction in the preoperative area with toys
e) IV placement in the preoperative holding area
Answer B.
Pharmacologic premedication is the only intervention proven to effectively reduce preoperative anxiety in children. Parental presence may be helpful in select cases, although it may cause significant anxiety in the parent. Distraction and behavioral preparation are probably effective in many cases, but not as effective as premedication with a benzodiazepine. IV placement in the holding area would effectively reduce the induction speed (and would allow for parenteral anxiolysis), but for many children entails an unacceptably high level of anxiety for during the IV placement procedure.