Hypnosis, clowns, and video games may help relax children before a general anesthetic

The prospect of having a general anesthetic can make anyone uneasy, but it can be especially distressing for children and their parents. Many children can't fully comprehend what's happening and why, and may become distraught or combative, attempting to squirm free when the facemask is fitted or the IV is administered. Sedatives such as midazolam can help relax a child before the anesthetic is given, but these drugs aren't without risks, such as breathing problems and what doctors call "paradoxical reactions," meaning that a child may actually become more anxious, rather than less.

Understandably, many parents and doctors are interested in nondrug approaches to relax and reassure a child who is having anesthesia. In a new review of studies, researchers have explored what seems to help and what doesn't. Surprisingly, having a parent around when an anesthetic is started falls under the latter category.

The researchers analyzed 17 studies with nearly 1,800 children between the ages of 10 months and 17 years. Eight of the studies looked at having a parent around while the anesthetic was being administered. All found that having a parent nearby didn't lessen a child's anxiety or improve his or her cooperation. "It is interesting that parental presence is often encouraged, even though it has not been shown to help," says lead research Allan Cyna of the Women's and Children's Hospital in Adelaide, Australia. "Based on our findings, we would recommend that parents do not need to stay for their child's anesthetic unless they are keen to do so."

One reason that a doting parent's presence might not be especially relaxing for a child is the parent's own heightened anxiety. Relaxation techniques directed at parents deserve further study, say the researchers. Acupuncture is one treatment that has shown a positive effect. In one study, children who needed anesthesia were less anxious if their parents had acupuncture to reduce their own anxiety. Future studies might also explore hypnosis, meditation, and yoga for parents, say the researchers.

But let's get back to the kids. The researchers also found that several approaches showed promise for directly easing anxiety in children. These included hypnosis, giving anesthesia in a calming, low-light environment, and having doctors dressed as clowns. One study even found that letting children play hand-held video games before the anesthetic was started reduced anxiety more than giving them a sedative.

However, not much research has been done on any of these treatments. In fact, the researchers found only one good study on each. So although the results were promising, we need more studies to know for certain what works, and what works best.

What you need to know. If your child needs a general anesthetic, there are things you can do to prepare yourself and your youngster. The American Academy of Pediatrics provides some helpful tips, including what types of words to use (talk about "taking a nap" rather than "being put under anesthesia") and what to tell different age groups (kids under 12 probably aren't ready to hear about any risks of surgery or anesthesia). You can also ask whether your hospital has any special programs for preparing children and families for anesthesia, including books and videos. You might also ask your doctor about the anxiety-reducing interventions mentioned above.

And don’t forget to gauge your own anxiety level. Kids can be very perceptive and often pick up on a parent's nervousness or sense of worry. If you're feeling anxious, you might look into acupuncture or another relaxation technique. You’ll likely feel better—and your child might very well, too.

—Sophie Ramsey, patient editor, BMJ Group

ConsumerReportsHealth.org has partnered with The BMJ Group (British Medical Journal) to monitor the latest medical research and assess the evidence to help you decide which news you should use.

Read more on how nature sounds can ease your child's fear of the dentist, and for more news and research on children's health, susbcribe to our free Child and Teen e-newsletter.

Comments

[Hypnotist seeker]

Hey great post..I have really enjoyed it and I do agree with..
That hypnosis is a very relaxing technique and same with the video games..they both give relaxation to the mind of children....
Thanks for sharing this information and I am looking forward for some more like this...Great !!!

[SEPainCare]

Children come in all shapes, sizes and personality types, and pediatric anesthesiologists must be able to read these little personalities and communicate with children of all ages. In fact, sensitivity and creativity can be the most practical day-to-day skill we have.

Working closely with parents gives us great insights into how to communicate with your child. Kids pick up on any anxiety you feel, so we make sure you fully understand what is happening with your child and what to expect during recovery.

And even with these new advances in care, the importance of good communication never wanes. It will always be crucial for physicians and parents to keep an open dialog going throughout the process of the child’s care. Your knowledge and expertise about the child is just as important as my medical knowledge. Together, we can make your child’s encounter with medicine a good one.
~Southeast Anesthesia Consultants, Charlotte, NC