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PEDIATRIC ANESTHESIA

Predicting Which Child-Parent Pair Will Benefit from Parental Presence During Induction of Anesthesia: A Decision-Making Approach

Zeev N. Kain, MD, MBA^*, Alison A. Caldwell-Andrews, PhD^*, Inna Maranets, MD, William Nelson, MD, and Linda C. Mayes, MD^*

*Center for the Advancement of Perioperative Health, and the Departments of Anesthesiology, Pediatrics & Child Psychiatry, and Child Study Center, Yale University School of Medicine, New Haven, Connecticut

Using a multiply matched, concurrent cohort analysis, with 568 subjects matched from data obtained by our laboratory over the past 7 yr, we examined whether parental presence during induction of anesthesia (PPIA) reduces children’s anxiety depending on the interaction between child and parent’s baseline anxiety. Children’s and parents’ baseline anxiety was assessed preoperatively; children’s anxiety was again assessed during induction of anesthesia. We found that anxious children who received PPIA from a calm parent were significantly less anxious during induction of anesthesia as compared with anxious children who did not receive PPIA (P = 0.03). In contrast, calm children who received PPIA from an overly anxious parent were significantly more anxious as compared with calm children who were not accompanied by a parent (P = 0.002). We found no effect of PPIA on children’s anxiety during induction of anesthesia when calm parents accompanied calm children into the operating room (P = 0.15) or when overly anxious parents accompanied anxious children (P = 0.49). We conclude that the presence of a calm parent does benefit an anxious child during induction of anesthesia and the presence of an overly anxious parent has no benefit.

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