AANA October 2026 Journal: Trauma-Informed Care: Considerations for Anesthesia Providers-Trauma-Informed Care: Considerations for Anesthesia Providers

Trauma-Informed Care: Considerations for Anesthesia Providers

Pdf Summary

This literature review examines perioperative anesthesia care for adults with posttraumatic stress disorder (PTSD), drawing on research published from 2014 to 2024. PTSD is common among surgical patients but often goes unrecognized, and anesthesia-related loss of control, sensory stimulation, and emergence may trigger distress, dissociation, anxiety, altered pain responses, or emergence delirium (ED). These reactions can endanger patients and staff, prolong recovery, and worsen patients’ willingness to seek future care.<br /><br />The authors recommend integrating trauma-informed care (TIC) throughout the perioperative period. Preoperative screening and sensitive, nonjudgmental communication can help identify triggers and learn patients’ preferences and coping strategies. During surgery and recovery, providers can reduce noise and unnecessary movement, use consistent staff and calm explanations, offer grounding or reassurance, and orient patients promptly during emergence.<br /><br />Pharmacologic strategies that may reduce ED include dexmedetomidine and total intravenous anesthesia with propofol. Magnesium sulfate and ketamine warrant further study, while benzodiazepines should be used cautiously because of possible associations with increased ED. Much of the medication evidence is not specific to patients with PTSD, and adult ED assessment lacks standardized tools.<br /><br />The review concludes that individualized, multidisciplinary care combining appropriate anesthetic planning with environmental and communication strategies may improve safety and patient experience. Wider adoption will require provider education, standardized screening and protocols, and stronger research evidence.

Keywords

PTSD

perioperative anesthesia

trauma-informed care

emergence delirium

preoperative screening

dexmedetomidine

propofol

ketamine

benzodiazepines

adult surgical patients