Preoperative parental anxiety predicts behavioural and emotional responses to induction of anaesthesia in children

Abstract

Parental presence at induction of anaesthesia is desirable if it makes the child happier and more cooperative. This study evaluated the emotional and behavioural responses of children to being accompanied by a parent at induction of anaesthesia in a paediatric day-care surgical centre. One hundred and thirty-four patients (aged 2-10 yr, ASA physical status I or II) were divided into two groups by day of surgery, to have a parent present at induction of anaesthesia (treatment group), or to be unaccompanied (control group). Before, and at one week after surgery, the child's fears and behaviour were scored by the Hospital Fears Inventory (HFI) and Behavioural Questionnaire (BQ), and parental anxiety by the Parents' Questionnaire (PQ) before and at one week after surgery. The Global Mood Scale (GMS) was used to assess the child's behaviour and the Visual Analogue Scale (VAS) to assess the parent's anxiety on arrival for surgery and at induction of anaesthesia. All patients and parents were disturbed by the experience, but to the same degree in the treatment and control groups. Subgroups of " calm " and " anxious " parents were identified by a median split of their preoperative VAS scores. Children in the" calm-treatment," " calm-control " and" anxious-control " subgroups were similarly upset at induction. Children in the" anxious-treatment " subgroup were the most disturbed at induction, and significantly more than those in the" anxious-control" subgroup. Preoperative parental anxiety levels also correlated with the child's fears and behaviour one week after surgery. Therefore, parental anxiety should be assessed preoperatively to allow"calm" parents to be present at induction if they wish, and"anxious" parents to be excluded and receive counselling and support. © 1990 Canadian Anesthesiologists.