State of the Art in Pediatric Anesthesia: A Narrative Review about the Use of Preoperative Time

Abstract

This review delves into the challenge of pediatric anesthesia, underscoring the necessity for tailored perioperative approaches due to children’s distinctive anatomical and physiological characteristics. Because of the vulnerability of pediatric patients to critical incidents during anesthesia, provider skills are of primary importance. Yet, almost equal importance must be granted to the adoption of a careful preanesthetic mindset toward patients and their families that recognizes the interwoven relationship between children and parents. In this paper, the preoperative evaluation process is thoroughly examined, from the first interaction with the child to the operating day. This evaluation process includes a detailed exploration of the medical history of the patient, physical examination, optimization of preoperative therapy, and adherence to updated fasting management guidelines. This process extends to considering pharmacological or drug-free premedication, focusing on the importance of preanesthesia re-evaluation. Structural resources play a critical role in pediatric anesthesia; components of this role include emphasizing the creation of child-friendly environments and ensuring appropriate support facilities. The results of this paper support the need for standardized protocols and guidelines and encourage the centralization of practices to enhance clinical efficacy.

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“…Administering anesthesia to children can be very challenging, as it can be affected by various factors like age, personality, history of prior medical procedures, family dynamics, and the expertise of medical practitioners [41]. It is crucial for anesthesiologists to focus on alleviating children's anxiety by promoting a nurturing setting, calming their apprehensions, and developing a relationship with the medical staff.…”

A Comprehensive Review on the Role of Melatonin's Anesthetic Applications in Pediatric Care

“…The benefits of sedative premedication include reducing both patient and parental apprehension, enhancing overall satisfaction, and facilitating the separation of the patient from their caregiver [ 26 , 27 ]. Decisions regarding preoperative tests hinge on factors such as the patient's clinical history, comorbidities, physical examination findings, and planned surgery [ 28 ]. The quest for the optimal route of premedication in children persists, with numerous studies exploring the pharmacokinetics, tolerability, efficacy, and safety of various formulations [ 28 ].…”

“…Decisions regarding preoperative tests hinge on factors such as the patient's clinical history, comorbidities, physical examination findings, and planned surgery [ 28 ]. The quest for the optimal route of premedication in children persists, with numerous studies exploring the pharmacokinetics, tolerability, efficacy, and safety of various formulations [ 28 ]. Among the commonly utilized sedative premedications in pediatric patients are midazolam, ketamine, and clonidine [ 27 ].…”