ABSTRACT
Preoperative anxiety in children is common and can have negative effects on their overall surgical experience. Several factors, such as age, personality traits, and past medical experiences, can contribute to increased preoperative anxiety. Behavioral interventions, such as distraction techniques, parental presence at induction of anesthesia, and preoperative preparation programs, can be effective in reducing anxiety. Behavioral family preparation programs have been found to reduce the number of children requiring preoperative sedation, but they may not be practical for all centers. Anesthesiologists and child life specialists can play an essential role in reducing anxiety in children by interacting with them in an age-appropriate way, providing therapeutic play experiences, and offering developmentally appropriate language. Distraction techniques, such as non-procedural distracting talk, electronic devices, music, stories, and guided imagery, can also help children cope with anxiety. Pharmacological interventions, such as sedative premedication, should be used with caution, especially for children with neurodevelopmental disorders, due to potential drug interactions and increased risks of upper airway obstruction.