Virtual Parental Presence on Induction of Anesthesia vs Premedication With Midazolam

Inclusion Criteria: * children from ages 4 years to 8 years old undergoing outpatient surgery * children identified as needing premedication * ASA physical status I, II or III * planned inhalational induction * children presenting from home prior to surgery (not an inpatient) * English speaking parents and child Exclusion Criteria: * children with developmental delay * children with psychological / emotional disorders * children with altered mental status * children in whom midazolam may be medically contraindicated per the discretion of the anesthesia care team * children with language barrier * children who are not accompanied by someone able to consent (ie legal guardian) * children who are inpatient prior to surgery * children with expected difficult intubation/airway * children presenting for emergency surgery * family history or personal history of malignant hyperthermia / risk of MH * consent not obtained or withdrawal of consent * children with past history of violent behaviors during induction of anesthesia * cancellation of surgery * patients with a diagnosis of COVID-19 or a patient under investigation for COVID-19, including patients being treated with airborne precautions in the operating room * receipt of any type of medical sedative prior to induction of anesthesia, including (but not limited to) ketamine, and/or dexmedetomidine.