Perioperative benzodiazepine use in the pediatric population: A narrative review

Abstract

Background: Pediatric patients undergoing surgery under anesthesia may experience anxiety and distress during the perioperative period, for which benzodiazepines (BZD) can be employed as premedication in these scenarios. For this reason, it is important to highlight the pharmacological profile, use, and possible side effects in the pediatric perioperative population. Methods: Narrative Review using the Pubmed, Scopus and Embase databases for articles between 2000 and 2021 in English and Spanish using the keywords “Benzodiazepines”, “Pediatric Anesthesiology”, “Pharmacology”, “Adverse Effects”, and “Cerebral Apoptosis” Results: The principal side effects seen with BZD use in children mainly revolves around neurological manifestations, which include sedation, respiratory depression and prolonged awakening. There is evidence on the effectiveness of BZD in the pediatric population, which is used in a limited number of situations, such as surgical procedures that trigger acute anxiety. Conclusion: BZD has been widely studied in the literature, however it is important to highlight the possible complications and level of safety in the pediatric population. It has been evidenced that prolonged treatments not only increase the severity of neurodegeneration in the most vulnerable cerebral regions, but also trigger certain connectomic pathologies through wallerian and transneuronal degeneration.