Premedication in Pediatric Anesthesia.*

100 Years of Pediatric Anesthesia With Anesthesia & Analgesia: Growing Together

“…In 1935, Leech 42 dedicated an entire article to preanesthetic medication in children, and Smith, Leigh, and Belton continued the discussion on chemical control of preoperative anxiety including barbiturates and opioids into the 1950s. 5,43 Beginning in the 1990s and continuing today, Zeev Kain, MD, MBA, picked up the torch and elevated the discussion by developing a standardized assessment tool to provide evidence-based practice. Through his work, predominantly published in A&A, Kain et al [44][45][46] drove the agenda on premedication, preoperative anxiety, postoperative behavioral outcomes, emergence delirium, anxiety measurement tools, and specific interventions.…”

“…Over the next several decades, A&A reported important progress in original articles by emerging specialists, M. Digby Leigh, MD, and M. Kathleen Belton, MD, CM, who were advocates of experienced anesthesiologists caring for children, premedication, and endotracheal intubation in pediatric ear, nose, and throat (ENT) procedures. [3][4][5] allowing an "open" anesthetic technique free of highresistance expiratory valves and rebreathing bags that caused "suboxygenation" in children (Figure). 11 Before the Ayre's T-piece, high-resistance "closedcircuit" breathing systems led to respiratory fatigue in small infants and significant rebreathing of expired air.…”

“…Over the next several decades, A&A reported important progress in original articles by emerging specialists, M. Digby Leigh, MD, and M. Kathleen Belton, MD, CM, who were advocates of experienced anesthesiologists caring for children, premedication, and endotracheal intubation in pediatric ear, nose, and throat (ENT) procedures. 3–5 Margery van N. Deming, MD, Chief of Anesthesia at Children’s Hospital of Philadelphia (1946–1955); Robert M. Smith, MD, Chief of Anesthesia at Children’s Hospital Boston (1946–1980); M. Digby Leigh, MD, Anesthetist-in-Chief at the Children’s Memorial Hospital in Montreal (1940–1947); and C. Ronald Stephen, MD, FFARCS, at that time, Chief of Anesthesia at Children’s Memorial Hospital, Montreal, Canada (1947–1950) represented rising stars at leading children’s hospitals throughout the United States and Canada. This esteemed group was published on the fundamentals of pediatric anesthesia for the general anesthesiologist in A&A , providing resources for those who had less experience with children.…”