Preoperative anxiety in children: prevention and management. A comprehensive review and analysis

Background: Preoperative anxiety frequently occurs among children. It has both immediate and enduring impacts on their growth, development, overall health, and postsurgical outcomes. Preventing and managing preoperative anxiety in children can reduce the occurrence of detrimental behaviors after surgery. This review aimed to investigate strategies for both preventing and managing preoperative anxiety in child surgical patients. Methods: Following the methodology employed for the systematic review, pertinent literature was sought from various databases and other sources. Recent evidence was identified using the following databases: SCOPUS, PubMed, Science Direct, Google Scholar, Cochrane Library, MEDLINE, and Embase. To refine the search and gather relevant supporting evidence, Medical Subject Headings (MeSH) were utilized alongside proximity and Boolean operators such as OR, AND, and NOT. Duplicate entries were removed using EndNote software, and a thorough screening of the literature was conducted using appropriate appraisal checklists. Results: Using sedative premedication, parental presence during anesthesia induction, and behavioral interventions are key components of anxiety management. Furthermore, case-specific preoperative interviews, educational videos, games, clown interactions, and virtual tours can all be effective if implemented appropriately. Distraction techniques such as deep breathing exercises, videos, or toys are highly effective, especially during stressful moments. Conclusions and recommendation: Controlling preoperative anxiety in children poses a significant challenge for anesthesiologists, and addressing anxiety is a crucial aspect of pre-anesthesia consultations and checkups. Therefore, assessing, prevention, and management of preoperative anxiety in children is crucial for smooth induction and better postoperative outcome.