The induction of anesthesia is a critical turning point in the perioperative process. It marks the transition from wakefulness to unconsciousness and is often accompanied by patient anxiety, uncertainty, and vulnerability. For anesthesiologists, induction requires not only technical expertise in administering anesthetic drugs but also effective communication with the patient. The dialogue that occurs in this period meaningfully impacts patient safety, trust, and overall surgical experience.
For many patients, anesthesia induction creates anxiety and distress. Fear of losing control, uncertainty about anesthesia, and concerns about postoperative pain or complications can contribute to heightened stress. Verbal communication, tone, and body language from the anesthesiologist play a central role in alleviating these fears for patients and improving the induction process. A calm, reassuring explanation of what the patient may feel helps normalize the experience and reduce panic 1–3.
Effective communication begins before induction itself, during the preoperative assessment. By listening attentively to patient concerns, answering questions clearly, and explaining what the patient will experience during anesthesia, anesthesiologists build rapport and trust. When patients feel heard and informed, they are more likely to cooperate during induction and experience less anxiety. Simple statements can provide reassurance and strengthen the therapeutic alliance 4,5.
As anesthetic drugs are administered, patients may experience rapid changes in sensation. Clear, concise, and empathetic instructions are essential at this stage. Examples include explaining what to expect, providing reassurance, or giving simple directions. During the early stages of induction, when patients may only be partially responsive, any speech from the anesthesiologist should be brief, supportive, and delivered with a calm tone. Nonverbal communication, like maintaining eye contact and gentle touch, also conveys safety and presence.
Beyond reassurance, communication during induction has direct safety implications. Patients who are calm and cooperative make it easier for healthcare providers to place intravenous lines, administer oxygen, and position airway devices. Conversely, heightened anxiety may lead to agitation, difficulty with cooperation, or hemodynamic instability. Effective communication reduces these risks. In addition, anesthesiologists must remain attentive to verbal cues from the patient in the moments before unconsciousness, as patients may share last-minute information about allergies, symptoms, or concerns that could influence care 9,10.
Special consideration is needed for pediatric patients, elderly patients, or those with language barriers. Children often require a modified, playful approach, sometimes involving parents during induction to ease separation anxiety. For individuals with cognitive impairment, simple and repeated reassurance is essential. The use of interpreters or culturally sensitive communication strategies ensures understanding and comfort across diverse patient populations 11–15.
Communication between patients and anesthesiologists during induction is a vital component of safe, patient-centered anesthesia care. By combining technical skill with clear, empathetic communication, anesthesiologists can reduce anxiety, enhance cooperation, and foster trust during one of the most vulnerable moments in a patient’s surgical journey. Ultimately, these interactions contribute to better patient experiences and improved clinical outcomes.
References
1. Kain, Z. N., Wang, S. M., Mayes, L. C., Caramico, L. A. & Hofstadter, M. B. Distress during the induction of anesthesia and postoperative behavioral outcomes. Anesth Analg 88, 1042–1047 (1999). DOI: 10.1097/00000539-199905000-00013
2. Lumb, A. B. et al. Investigating the causes of patient anxiety at induction of anaesthesia: A mixed methods study. J Perioper Pract 31, 246–254 (2021). DOI: 10.1177/1750458920936933
3. Sriharika, B. & Upputuri, V. S. The Impact of Preoperative Anxiety on Anesthesia Induction: A Comparative Study of Different Sedative Protocols. Journal of Contemporary Clinical Practice 11, 252–257 (2025). DOI : 10.61336/jccp/25-06-38
4. Nene, A., Sriramka, B., Jain, M., Biswal, P. & Shyam, A. Partners in Precision: Cultivating Trust and Respect in the Surgeonanesthetist Dynamics. J Orthop Case Rep 14, 3–5 (2024). DOI: 10.13107/jocr.2024.v14.i05.4412
5. Butt, M. F. Approaches to building rapport with patients. Clin Med (Lond) 21, e662–e663 (2021). DOI: 10.7861/clinmed.2021-0264
6. D’Andria Ursoleo, J., Bottussi, A. & Monaco, F. Talk before they sleep: strategies for patient-centred communication in anaesthesiology. British Journal of Anaesthesia 133, 934–939 (2024). DOI: 10.1016/j.bja.2024.08.013
7. Smith, A. F. & Mishra, K. Interaction between anaesthetists, their patients, and the anaesthesia team. BJA: British Journal of Anaesthesia 105, 60–68 (2010). DOI: 10.1093/bja/aeq132
8. Bizzio, R. et al. Exploring Non-Pharmacological Management among Anesthesia Providers to Reduce Preoperative Distress in Children. Journal of Pediatric Nursing 50, 105–112 (2020). DOI: 10.1016/j.pedn.2019.11.005
9. Kharod, U., Panchal, N. N., Varma, J. & Sutaria, K. Effect of pre-operative communication using anaesthesia information sheet on pre-operative anxiety of patients undergoing elective surgery—A randomised controlled study. Indian J Anaesth 66, 559–572 (2022). DOI: 10.4103/ija.ija_32_22
10. Bello, C. M., Eisler, P. & Heidegger, T. Perioperative Anxiety: Current Status and Future Perspectives. J Clin Med 14, 1422 (2025). DOI: 10.3390/jcm14051422
11. Crowe, A.-M. L. Communication skills with children in paediatric anaesthesia: challenges while wearing a face mask. BMJ Paediatr Open 4, e000846 (2020). DOI: 10.1136/bmjpo-2020-000846
12. Mann, C. M. & Kennedy, C. Identifying the core attributes of pediatric communication techniques to be taught to anesthetic trainees. Paediatr Anaesth 30, 614–623 (2020). DOI: 10.1111/pan.13846
13. Ballacchino, M. M., Deiner, S. G., Martinez-Camblor, P. & Ron, D. Perspectives of Older Patients on Speaking With an Anesthesia Provider Before the Day of Surgery: A Cross-Sectional Study. A A Pract 19, e01875 (2025). DOI: 10.1213/XAA.0000000000001875
14. Tylee, M. J. et al. Anesthesiologist to Patient Communication. JAMA Netw Open 3, e2023503 (2020). DOI: 10.1001/jamanetworkopen.2020.23503
15. Smith, A. F. & Mishra, K. Interaction between anaesthetists, their patients, and the anaesthesia team. Br J Anaesth 105, 60–68 (2010). DOI: 10.1093/bja/aeq132
