Reducing children's psychological stress in the operating suite.

Children often experience extremely high levels of psychological stress in the operating suite because of anxiety associated with the separation from their parents, the unfamiliar and intimidating environment, the presence of strangers in unusual attire (masks, caps, and gowns), the act of being forcibly restrained, and the forceful pressing over the mouth and nose of an anesthetic mask that emits a foul-smelling gas and that seems to restrict breathing in a manner reminiscent of suffocation. The recovery room can be very frightening for children because of the separation from parents and the frequently overpowering scene of human injury and suffering. If the personnel in the operating suite are trained in child development, and if they are encouraged to practice elementary "preventive psychiatry" and to use common sense, then the psychological morbidity resulting from the experience in the operating suite can be minimized. Arrangements ought to be made for children undergoing relatively simple and short operations to go to a place different from the "intensive-care" type of recovery room.