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

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. ©Canadian Anesthesiologists Society 2008.