Background: Pediatric patients undergoing surgery under anesthesia may experience anxiety and distress during the perioperative period, for which benzodiazepines (BZD) can be employed as premedication in these scenarios. For this reason, it is important to highlight the pharmacological profile, use, and possible side effects in the pediatric perioperative population. Methods: Narrative Review using the Pubmed, Scopus and Embase databases for articles between 2000 and 2021 in English and Spanish using the keywords "Benzodiazepines", "Pediatric Anesthesiology", "Pharmacology", "Adverse Effects", and "Cerebral Apoptosis" Results: The principal side effects seen with BZD use in children mainly revolves around neurological manifestations, which include sedation, respiratory depression and prolonged awakening. There is evidence on the effectiveness of BZD in the pediatric population, which is used in a limited number of situations, such as surgical procedures that trigger acute anxiety. Conclusion: BZD has been widely studied in the literature, however it is important to highlight the possible complications and level of safety in the pediatric population. It has been evidenced that prolonged treatments not only increase the severity of neurodegeneration in the most vulnerable cerebral regions, but also trigger certain connectomic pathologies through wallerian and transneuronal degeneration.

Endotracheal intubation (ETI) is indicated to protect and control the airway. As in any medical process, patients who require advanced airway management are not exempt from experiencing sequelae, especially when more manipulation is required to secure the airway, or in combination with procedures that may affect airway structures such as adenotonsillectomy. It is important to keep in mind that short-term intubation in healthy patients can result in significant tracheal inflammation at the microscopic level without creating symptoms. This finding has been demonstrated by studies such as the one done by Puyo et al. 1 which showed that adult patients intubated for 3 h during surgical procedures had a 10-fold increase in the number of polymorphonuclear cells between intubation and extubation. The innate immune system intervenes in the perioperative period since it is involved in the pathophysiological characteristics of subglottic stenosis and other endotracheal injuries secondary to ETI because the tracheal mucosa is constantly exposed to endogenous

No abstract