Preparing Parents to Be Present for Their Child’s Anesthesia Induction: A Randomized Controlled Trial

Anesthesia & Analgesia: October 2015 – Volume 121 – Issue 4 – p 1001–1010

AUTHORS: Bailey, Kristen M. MSc et al

BACKGROUND: The purpose of this study is to compare the effectiveness of a brief preparation intervention for parental presence during induction of anesthesia (PPIA preparation) with a PPIA with standard preparation (PPIA standard).

METHODS: Ninety-three children, aged 2 to 10 years, undergoing elective surgery at a children’s hospital participated together with their parents. Parents were randomly assigned to receive either PPIA preparation or PPIA standard before their children’s induction of anesthesia. Children of parents assigned to each group were compared on measures of preoperative anxiety, cooperation at induction, emergence delirium, and postoperative pain. Parents were compared on measures of state anxiety and self-efficacy about their role in the operating room (OR).

RESULTS: The effectiveness of parental presence in reducing children’s preoperative anxiety was not improved by the intervention at the holding stage (P =0.15, Wilcoxon Mann-Whitney odds [WMWodds; 95% confidence interval {CI}] = 1.41 [0.75–3.10]), the point at which the family left the holding area (P = 0.39, WMWodds [95% CI] = 1.18 [0.60–2.45]), the point that they entered the OR (P =0.28, WMWodds [95% CI] = 1.23 [0.65–2.67]), or the point at which the anesthesia mask was introduced (P = 1.3, WMWodds [95% CI] = 1.23 [0.64–2.63]). However, parents who received PPIA preparation trended toward greater self-efficacy about their role in the OR than those who received PPIA standard (P = 0.03, WMWodds [95% CI] = 1.69 [1.07–2.87]).

CONCLUSIONS: A brief, video-based intervention aimed at preparing parents to be present for their child’s anesthesia induction was not successful in reducing the children’s preoperative anxiety. However, it is unclear whether parents included in this study actually performed as instructed in the intervention to reduce their children’s anxiety. Future research should monitor parent behavior and support parental performance to reduce their children’s preoperative anxiety.