Children requiring repeated visits to the operating room or imaging suite may develop severe anxiety and a host of behavioral responses. Multiple sources are available to prepare children for their visit: non-pharmacologic tools (parental presence, distraction, explanation), premedication, and hospital-based resources (preoperative visit, web-based information) may help alleviate some of the stress involved with these encounters.

The discussion surrounding anesthesia neurotoxicity has been increasing and most surgeons are now faced with a host of questions from parents regarding the risk to their children. Most experts agree that if surgery or imaging is required, we must remember that there is no definitive causal evidence that neurotoxicity will result from being exposed to anesthesia. Withholding necessary treatment though has definitive risks. For completely elective procedures, it would seem prudent to consider the risks and benefits of delaying until the child is older. However, this age has not yet been defined. Research is ongoing and the results of three large multicenter studies, the GAS trial, PANDA study, and MASK study will help guide future management.