An evidence-based review of parental presence during anesthesia induction and parent/child anxiety.
OBJECTIVE
The purpose of this evidence-based review was to examine the effect of parental presence during anesthesia induction on parents' and children's anxiety.


METHODS
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).


RESULTS
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.


CONCLUSIONS
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.
Chundamala
Josie
J
Department of Surgery, The Hospital for Sick Children, 555 University Avenue, Room 1218, Black Wing, Toronto, ON, Canada M5G 1X8. josie.chundamala@sickkids.ca
Wright
James G
JG
Kemp
Sheelagh M
SM
D000759:Adjuvants, Anesthesia / Q000627:therapeutic use; D000758:Anesthesia / Q000379:methods* / Q000523:psychology*; D001007:Anxiety / Q000188:drug therapy / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D019317:Evidence-Based Medicine; D006801:Humans; D008874:Midazolam / Q000627:therapeutic use; D010290:Parents / Q000523:psychology; D011229:Preanesthetic Medication; D011300:Preoperative Care / Q000379:methods*; D002666:Psychology, Child; D016032:Randomized Controlled Trials as Topic; D013315:Stress, Psychological / Q000150:complications* / Q000188:drug therapy; D016896:Treatment Outcome
D000759:Adjuvants, Anesthesia; D008874:Midazolam