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In2513328001071966
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some425342001073380152194
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infections188539800107196689131171201219266314346
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The2380398001074291134
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such2525664001073379118164
as2703664001074072
the2789664001072874117
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Web8566780010773113161
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and606692001074087135
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Another17796920010753100147173220263288
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However,24457060010756103167209248290315326
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children,3728272001074087104122170195237284298
especially4050272001074476125168209226265283300339
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448702720010744
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those3047286001072875122154197
with3261286001076583109156
certain3434286001074082107136176194240
temperamental3691286001072869141190233258298371414460486526544
characteristics4252286001074086126151191230259300325343375402420459492
[4].47612860010926689148492860010716
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most35603000010773123157187
parents3772300001074992119163212240276
prefer4072300001075078122146191218
PPIA4315300001074590108161
to4501300001072875
reduce4601300001072670121169211254
their4880300001072877122141169
child’s5073300001074089109128178196228
preoperative53253000010750781221723047314001075096123165193213255299
anxiety,3365314001074190130150195224267280
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suggests4300314001073482132182227262292327
that4646314001072877119147
the4812314001072777122
effectiveness495231400107446997141184215234276321370415449484
of5454314001074873
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is3597328001071952
questionable.3669328001074897142176206226275325366417437482498
In4186328001071968
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PPIA4617328001074590109162
always4798328001074161126169208243
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some5324328001073483158203
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pressure53463420010749771211553047356001073380106149
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staff4925356001073462104127155
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supervise5188356001073379129173200243263295339
parents.3047370001075092119163212240276293
On33613700010760110
the3491370001072877122
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hand,3851370001074890139189206
PPIA4077370001074590109161
increases4259370001071867109136180221255300335
parents’4614370001075092119163212240276292
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with5364370001076585114163
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perioperative3194384001075096123143192243289317359387407449493
process3712384001075078126168211246280
and4017384001074190140
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their4518384001072877122142169
rights471238400107274797146173209
as4946384001074176
well50473840010765109129149
as5221384001074175
those5321384001072877127161206
of3047398001074873
their3141398001072877122142169
children3332398001074089108128178205249298
[2].36523980010926729737483980010716
Despite31874120010757100131178195221261
some3461412001073379150192
shortcomings,3666412001073378124149177214258329345391438468482
pharmacological4161412001074995133158229267306350367413460477515554571
premedication4745412001074973114185227274291329368393409455501
remains5259412001072666137176192238268
the3047426001072874116
most31764260010773119151178
effective336742600107436591132171199216255297
method36774260010773115141187233281
of3971426001074870
preventing4054426001074974115154195241266283329376
preoperative4443426001074974115162210253277317342359398439
anxiety4895426001074187124141183209249
in5158426001071864
children.5235426001074086103119166191232278292
Inappropriate3047440001071965103150198223268316341358396421462
dose,3522440001074894126168181
route,3716440001072671117143183196
or3925440001074772
time4011440001072744115157
of4181440001074769
administration4264440001074087158175221237268295320359384401447493
are4770440001074165106
the4889440001072874116
most50184400010773119150177
common5208440001074085156227273320
reasons3047454001072768107139186233265
for332645400107247096
failure34364540010723648299145170212
of3662454001074870
pharmacological3747454001074997136161234274313358376423472489528568586
premedication4347454001075075117189232281298337377403421467514
[2].48764540010926709249654540010716
Midazolam,4995454001077088135175211256275314386400
the5410454001072774117
most30474680010773119150177
commonly3237468001074084156226273319336374
used3624468001074778120167
agent3804468001074188129175200
for401746800107236993
sedative4123468001073476123162187204242283
premedication4419468001074974115186228276292330369395411457503
in4935468001071965
children,5013468001073985101118165189230276289
fails53154680010724648097127
to5456468001072771
achieve3047482001074078124140181219260
adequate3320482001074087128176221259284324
quality3657482001074792131147164190230
of3899482001074869
sedation3981482001073375122160185202247293
in4287482001071964
up4364482001074794
to4470482001072872
20%4555482001074383148
of4715482001074769
cases.4797482001074078109151182197
Another5007482001075297143168214255280
option5299482001074795120137182228
for304749600107247197
premedication3167496001075177119192235284302341382408426473521
is3712496001071951
the3787496001072875118
administration3929496001074290163181228245277305331372398416463511
of4464496001074871
the4559496001072875119
selective470249600107347795138179208226266308
α2-adrenergic5034496001074993117157205231273320364389436454493
receptor3047510001072768108149198224270295
agonists3366510001074189136183201232260293
dexmedetomidine3683510001074992130203246295338364410483500548565612655
or4361510001074874
clonidine4459510001074057104152169217234281324
which48075100010765112129168215
have5046510001074887126168
sedative5237510001073477126165191209248290
and3047524001074188136
anxiolytic3207524001074188126144191209248278296335
effects356552400107446793135175204238
comparable3827524001074085158207247272313361380423
to4273524001072874
midazolam.4370524001077492140179215261280319391406
Some4800524001074289162206
authors5029524001074188115162209235268
prefer5320524001075076118140183208
the3047538001072875118
use3179538001074879122
of3315538001074871
ketamine3400538001073880106146218236282325
[2].37405380010926709238295380010716
An3859538001075399
algorithm3973538001074058106153179197223270342
for432953800107247096
managing44395380010774113160199247265311359
preoperative4812538001075076117165214257282323348366406447
anxiety5274538001074087125143186212253
in3047552001071965
children3127552001074087104121169194236283
is3424552001071951
shown3489552001073480127191238
in3742552001071965
Fig.3822552001074158106121
1.3958552001074353
If4026552001071941
premedication4082552001075075117189232281298337377403420467514
fails46115520010724648299130
in4756552001071965
a48365520010741
child4891552001074187104122170
with5075552001076583110157
vascular5246552001074181113153199217256281
access,3047566001074181118160192226242
the3315566001072877121
desired3463566001074993127145172215266
level3755566001071963104148167
of3949566001074872
sedation4048566001073378128169196215264313
and4387566001074189139
anxiolysis4553566001074189129148196216256291309342
can4921566001074182131
be5078566001075095
achieved5200566001074182130149193234277327
pharmacologically3047580001074996136161234274313359377424473491530571589606645
(intranasal370858000107234188113139180227266299339357
or4081580001074773
intramuscular416958000107196692117158230276308348394412452477
administration4662580001074088160178224242274302328368394412459507
is5184580001071950
also525058000107405890137
possible),5402580001074997304759400107336684133152196217230
or3294594001074774
induction3384594001071966115162202232250298346
of3746594001074871
general3834594001074892139183209250269
anaesthesia4119594001074188128172205234282325359376416
can4552594001073980128
be4696594001074994
started4806594001073462103129160202251
immediately.5073594001071992165208258276316343385404443455
Pathophysiology30476180015371133184258323393466527581622687726790853917
of39876180015363112
stress41226180015351104165226280334
response44796180015359120174245311384438499
in50016180015338114
the51376180015351125184
brain30476320015369129193235311
Severe3047650001074185125167193235
stress329865000107336187129162195
in3509650001071865
the3590650001072875118
child3724650001074087105123171
leads3911650001071962102150182
to4109650001072873
an4198650001074188
activation4302650001074080109128168209235253300348
of4666650001074771
the4753650001072774118
archicortex,4887650001074066104151169208254280311352391408
which53116500010764112130169216
is3047664001071952
located3123664001071967108150177219269
mainly34166640010774115133181200240
in3680664001071967
the3771664001072876120
hippocampus3915664001074867116167216257298372421470503
and4442664001074189138
is4604664001071952
functionally4680664001072372120161191210258307347366385425
involved5129664001071966106153173214257307
in5460664001071967
the3047678001072875119
limbic3182678001071937110159177217
system.3415678001073474107136178251267
In3698678001071966
the3780678001072876119
most39156780010773121154183
severe4114678001073377117160186228
cases,4358678001074081114158191206
the4581678001072775118
child4716678001073987105123172
experiences4904678001074383132176202221265312352394427
tonic5347678001072874122140180
immobility3047692001071992165213263282301319347389
(TI),345369200107236889112125
also359569200107405992140
known3751692001073888136200249
in4016692001071967
the4099692001072876120
literature423569200107193865108134175202250276319
as4571692001074073
the4661692001072876119
freezing479769200107235194138175194242291
response,5105692001072669102151200248281325340
in5461692001071966
which30477060010764112129169216
the3278706001072875118
paleocortex3412706001074989107150198238284310340382420
is3848706001071950
particularly3914706001074990115145163203249268307333352391
active4320706001074180110128168210
[6].45467060010925689246367060010715
TI4667706001074161
is4743706001071951
induced4809706001071966114160200241290
in5115706001071865
the5196706001072774118
event5329706001074383125172198
of3047720001074872
imminent3136720001071892165184232276324351
threat3504720001072876102145185212
and3733720001074189138
is3888720001071952
characterised3956720001074088129155197238268310337356389433483
by4456720001075089
a45627200010741
reversible,4619720001072770111154180214233282302346360
profound4996720001075077124148195243291341
state5354720001073362104131173