Preoperative medications are helpful for a variety of reasons. They may make it easier for the child to separate from the parents, may make it easier to induce the child and may help with postoperative pain relief. Oral premedicants are usually tolerated better than other routes. Common oral premedicants are oral fentanyl or midazolam, usually mixed with juices or oral analgesics to mask the taste. Fentanyl may also be formulated into a lozenge or lollipop for better appeal to the child.
Anesthetic induction is performed via mask for most pediatric patients.
Care should be taken to make the patient comfortable by having the child bring a favorite toy or blanket into the operating room. It is not unusual to have a parent accompany the child to the operating room for induction, although this practice may vary from institution to institution. Consent for the parents should be cleared from all medical personnel involved before proceeding to the operating room. Extremely nervous parents may hinder rather than help the child during the anesthetic induction. Although the anesthetic gases have a distinctive smell, that smell may be masked by using oils that resemble bubble gum, fruit or other aromatic smells.