What helps children cope with anxiety before an operation?

The main thing to do is be calm and make the child feel safe. It is easier for them to cope with the situation when they feel safe and protected. Aside from that, different children handle the idea of upcoming surgery differently. So parents can try to find out what helps their child to cope better.

Children are generally very curious and want to learn about things, and surgery is no exception. Parents and doctors might worry that talking to children about the operation could scare them. But avoiding the subject sometimes has the opposite effect: Not knowing what is going to happen might actually make them feel more scared. Children have usually already picked up some information about surgery and hospitals – for example, from the internet.

You can help them worry less by listening to their concerns and answering any questions they have. For example, children often want to know whether the operation will hurt or whether they will have an injection. Honest answers can help them to be better prepared.

A lot of children want to take a toy along. Things like their favorite soft toy, blanket or pacifier may be comforting.

A number of activities can help children by making it easier for them to understand what happens in a hospital. For instance, reading to them, telling them stories, drawing pictures, and putting on plays or puppet shows can prepare them for what will happen or offer distraction. Studies show that picture books that explain surgeries in a child-friendly way help reduce fears about the procedure. Listening to music beforehand has also been shown to help relieve anxiety in children and teenagers. Different people will be able to relax to different types of music, depending on their personal taste in music.

It is important that hospital staff can interact well with the child. Children's hospitals, in particular, are very attuned to the needs of children. Playful elements are used to make things easier for children when, for example, they have to take medication or go into the anesthesia room.

Initial studies suggest that films, computer games and clowns dressed as doctors can help children feel less anxious before operations.

VR (virtual reality) headsets can also help with anxiety. Putting on the headset instantly transports the user to another world – for example, an underwater world or a peaceful natural landscape. This is meant to help you relax or simply take your mind off things. And VR headsets can be used to provide information about the procedure. Some hospitals in Germany are already using these headsets.

Children deal with the situation leading up to surgery in different ways. Distraction works better for some children than it does for other, for instance. It also depends on the children's preferences – like whether they are more into reading or playing video games. Age is also a factor.

Children may be given a low dose of a sleeping pill or sedative shortly before the procedure if they are still very scared. It is typically used in liquid form, but it can also be given as a suppository or nasal drops if necessary. The most common active ingredient used for this is midazolam. The possible side effects include dizziness, confusion after waking up after surgery (delerium), headaches and gastrointestinal (stomach and bowel) problems. All of this is discussed during a pre-anesthesia consultation with the anesthesiologist. That is an opportunity for parents and children to ask questions and voice their concerns.