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Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie 1/2009

01-01-2009 | Review Articles/Brief Reviews

An evidence-based review of parental presence during anesthesia induction and parent/child anxiety

Authors: Josie Chundamala, MA, James G. Wright, MD, Sheelagh M. Kemp, MD

Published in: Canadian Journal of Anesthesia/Journal canadien d'anesthésie | Issue 1/2009

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Abstract

Purpose

The purpose of this evidence-based review was to examine the effect of parental presence during anesthesia induction on parents’ and children’s anxiety.

Source

MEDLINE (1950 to 2008) and EMBASE (1980 to 2008) were searched. Studies were restricted to randomized controlled trials (RCTs) and comparative studies only (levels of evidence I–III).

Principal findings

Fourteen studies that provided level II or level III evidence were included (nine RCTs, four prospective comparative studies, and one retrospective comparative study). Of the 10 studies that evaluated parents’ anxiety, most did not find parental presence to be more effective than no parental presence, midazolam, or parental presence plus midazolam. Of the 11 studies that examined children’s anxiety, most did not find parental presence to be more effective than no parental presence, midazolam, parental presence plus midazolam, or parental presence plus a video game.

Conclusion

Contrary to popular belief, in most cases parental presence does not appear to alleviate parents’ or children’s anxiety. In the rare instances when it does seem to diminish parents’ or children’s anxiety, premedicating children with midazolam has shown to be a viable alternative. Other anxiety-reducing solutions, such as distracting children with video games, should also be considered.
Literature
1.
go back to reference Wright JG, Swiontkowski MF, Heckman JD. Introducing levels of evidence to the journal. J Bone Joint Surg Am 2003; 85-A: 1–3.PubMed Wright JG, Swiontkowski MF, Heckman JD. Introducing levels of evidence to the journal. J Bone Joint Surg Am 2003; 85-A: 1–3.PubMed
2.
go back to reference Bevan JC, Johnston C, Haig MJ, et al. Preoperative parental anxiety predicts behavioural and emotional responses to induction of anaesthesia in children. Can J Anaesth 1990; 37: 177–82.PubMed Bevan JC, Johnston C, Haig MJ, et al. Preoperative parental anxiety predicts behavioural and emotional responses to induction of anaesthesia in children. Can J Anaesth 1990; 37: 177–82.PubMed
3.
go back to reference Blesch P, Fisher ML. The impact of parental presence on parental anxiety and satisfaction. AORN J 1996; 63: 761–8.PubMedCrossRef Blesch P, Fisher ML. The impact of parental presence on parental anxiety and satisfaction. AORN J 1996; 63: 761–8.PubMedCrossRef
4.
go back to reference Palermo TM, Tripi PA, Burgess E. Parental presence during anaesthesia induction for outpatient surgery of the infant. Paediatr Anaesth 2000; 10: 487–91.PubMedCrossRef Palermo TM, Tripi PA, Burgess E. Parental presence during anaesthesia induction for outpatient surgery of the infant. Paediatr Anaesth 2000; 10: 487–91.PubMedCrossRef
5.
go back to reference Hickmott KC, Shaw EA, Goodyer I, Baker RD. Anaesthetic induction in children: the effects of maternal presence on mood and subsequent behaviour. Eur J Anaesthesiol 1989; 6: 145–55.PubMed Hickmott KC, Shaw EA, Goodyer I, Baker RD. Anaesthetic induction in children: the effects of maternal presence on mood and subsequent behaviour. Eur J Anaesthesiol 1989; 6: 145–55.PubMed
6.
go back to reference Amanor-Boadu SD. The effect of parental presence at induction of anaesthesia on the behaviour of unsedated Nigerian children presenting for day-case anaesthesia. West Afr J Med 2002; 21: 28–30.PubMed Amanor-Boadu SD. The effect of parental presence at induction of anaesthesia on the behaviour of unsedated Nigerian children presenting for day-case anaesthesia. West Afr J Med 2002; 21: 28–30.PubMed
7.
go back to reference Kain ZN, Caldwell-Andrews AA, Maranets I, Nelson W, Mayes LC. Predicting which child-parent pair will benefit from parental presence during induction of anesthesia: a decision-making approach. Anesth Analg 2006; 102: 81–4.PubMedCrossRef Kain ZN, Caldwell-Andrews AA, Maranets I, Nelson W, Mayes LC. Predicting which child-parent pair will benefit from parental presence during induction of anesthesia: a decision-making approach. Anesth Analg 2006; 102: 81–4.PubMedCrossRef
8.
go back to reference Patel A, Schieble T, Davidson M, et al. Distraction with a hand-held video game reduces pediatric preoperative anxiety. Paediatr Anaesth 2006; 16: 1019–27.PubMedCrossRef Patel A, Schieble T, Davidson M, et al. Distraction with a hand-held video game reduces pediatric preoperative anxiety. Paediatr Anaesth 2006; 16: 1019–27.PubMedCrossRef
9.
go back to reference Johnston CC, Bevan JC, Haig MJ, Kirnon V, Tousignant G. Parental presence during anesthesia induction. A research study. AORN J 1988; 47: 187–94.PubMedCrossRef Johnston CC, Bevan JC, Haig MJ, Kirnon V, Tousignant G. Parental presence during anesthesia induction. A research study. AORN J 1988; 47: 187–94.PubMedCrossRef
10.
go back to reference Cameron JA, Bond MJ, Pointer SC. Reducing the anxiety of children undergoing surgery: parental presence during anaesthetic induction. J Paediatr Child Health 1996; 32: 51–6.PubMedCrossRef Cameron JA, Bond MJ, Pointer SC. Reducing the anxiety of children undergoing surgery: parental presence during anaesthetic induction. J Paediatr Child Health 1996; 32: 51–6.PubMedCrossRef
11.
go back to reference Kain ZN, Mayes LC, Caramico LA, et al. Parental presence during induction of anesthesia. A randomized controlled trial. Anesthesiology 1996; 84: 1060–7.PubMedCrossRef Kain ZN, Mayes LC, Caramico LA, et al. Parental presence during induction of anesthesia. A randomized controlled trial. Anesthesiology 1996; 84: 1060–7.PubMedCrossRef
12.
go back to reference Kain ZN, Mayes LC, Wang SM, Caramico LA, Hofstadter MB. Parental presence during induction of anesthesia versus sedative premedication: which intervention is more effective? Anesthesiology 1998; 89: 1147–56.PubMedCrossRef Kain ZN, Mayes LC, Wang SM, Caramico LA, Hofstadter MB. Parental presence during induction of anesthesia versus sedative premedication: which intervention is more effective? Anesthesiology 1998; 89: 1147–56.PubMedCrossRef
13.
go back to reference Kain ZN, Mayes LC, Wang SM, Caramico LA, Krivutza DM, Hofstadter MB. Parental presence and a sedative premedicant for children undergoing surgery: a hierarchical study. Anesthesiology 2000; 92: 939–46.PubMedCrossRef Kain ZN, Mayes LC, Wang SM, Caramico LA, Krivutza DM, Hofstadter MB. Parental presence and a sedative premedicant for children undergoing surgery: a hierarchical study. Anesthesiology 2000; 92: 939–46.PubMedCrossRef
14.
go back to reference Kain ZN, Caldwell-Andrews AA, Mayes LC, Wang SM, Krivutza DM, LoDolce ME. Parental presence during induction of anesthesia: physiological effects on parents. Anesthesiology 2003; 98: 58–64.PubMedCrossRef Kain ZN, Caldwell-Andrews AA, Mayes LC, Wang SM, Krivutza DM, LoDolce ME. Parental presence during induction of anesthesia: physiological effects on parents. Anesthesiology 2003; 98: 58–64.PubMedCrossRef
15.
go back to reference Kain ZN, Caldwell-Andrews AA, Wang SM, Krivutza DM, Weinberg ME, Mayes LC. Parental intervention choices for children undergoing repeated surgeries. Anesth Analg 2003; 96: 970–5.PubMedCrossRef Kain ZN, Caldwell-Andrews AA, Wang SM, Krivutza DM, Weinberg ME, Mayes LC. Parental intervention choices for children undergoing repeated surgeries. Anesth Analg 2003; 96: 970–5.PubMedCrossRef
16.
go back to reference Arai YC, Kandatsu N, Ito H, et al. Induction and emergence behavior of children undergoing general anesthesia correlates with maternal salivary amylase activity before the anesthesia. Acta Anaesthesiol Scand 2008; 52: 285–8.PubMed Arai YC, Kandatsu N, Ito H, et al. Induction and emergence behavior of children undergoing general anesthesia correlates with maternal salivary amylase activity before the anesthesia. Acta Anaesthesiol Scand 2008; 52: 285–8.PubMed
17.
go back to reference Ono S, Oikawa I, Hirabayashi Y, Manabe Y. Preparation of a picture book to support parents and autonomy in preschool children facing day surgery. Pediatr Nurs 2008; 34: 82–3.PubMed Ono S, Oikawa I, Hirabayashi Y, Manabe Y. Preparation of a picture book to support parents and autonomy in preschool children facing day surgery. Pediatr Nurs 2008; 34: 82–3.PubMed
18.
go back to reference Chan CS, Molassiotis A. The effects of an educational programme on the anxiety and satisfaction level of parents having parent present induction and visitation in a postanaesthesia care unit. Paediatr Anaesth 2002; 12: 131–9.PubMedCrossRef Chan CS, Molassiotis A. The effects of an educational programme on the anxiety and satisfaction level of parents having parent present induction and visitation in a postanaesthesia care unit. Paediatr Anaesth 2002; 12: 131–9.PubMedCrossRef
19.
go back to reference Rice M, Glasper A, Keeton D, Spargo P. The effect of a preoperative education programme on perioperative anxiety in children: an observational study. Paediatr Anaesth 2008; 18: 426–30.PubMedCrossRef Rice M, Glasper A, Keeton D, Spargo P. The effect of a preoperative education programme on perioperative anxiety in children: an observational study. Paediatr Anaesth 2008; 18: 426–30.PubMedCrossRef
20.
go back to reference Li HC, Lopez V. Effectiveness and appropriateness of therapeutic play intervention in preparing children for surgery: a randomized controlled trial study. J Spec Pediatr Nurs 2008; 13: 63–73.PubMedCrossRef Li HC, Lopez V. Effectiveness and appropriateness of therapeutic play intervention in preparing children for surgery: a randomized controlled trial study. J Spec Pediatr Nurs 2008; 13: 63–73.PubMedCrossRef
21.
go back to reference Kain ZN, Caldwell-Andrews AA, Mayes LC, et al. Family-centered preparation for surgery improves perioperative outcomes in children: a randomized controlled trial. Anesthesiology 2007; 106: 65–74.PubMedCrossRef Kain ZN, Caldwell-Andrews AA, Mayes LC, et al. Family-centered preparation for surgery improves perioperative outcomes in children: a randomized controlled trial. Anesthesiology 2007; 106: 65–74.PubMedCrossRef
22.
go back to reference Kain ZN, MacLaren J, McClain BC, et al. Effects of age and emotionality on the effectiveness of midazolam administered preoperatively to children. Anesthesiology 2007; 107: 545–52.PubMedCrossRef Kain ZN, MacLaren J, McClain BC, et al. Effects of age and emotionality on the effectiveness of midazolam administered preoperatively to children. Anesthesiology 2007; 107: 545–52.PubMedCrossRef
Metadata
Title
An evidence-based review of parental presence during anesthesia induction and parent/child anxiety
Authors
Josie Chundamala, MA
James G. Wright, MD
Sheelagh M. Kemp, MD
Publication date
01-01-2009
Publisher
Springer-Verlag
Published in
Canadian Journal of Anesthesia/Journal canadien d'anesthésie / Issue 1/2009
Print ISSN: 0832-610X
Electronic ISSN: 1496-8975
DOI
https://doi.org/10.1007/s12630-008-9008-3

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