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Parental presence during induction of anesthesia in children undergoing tonsillectomy and adenoidectomy
Xin Li1, Xiao-Feng Qiao2, Peng-Xia Ren3
1Department of Surgery, Children's Hospital of Shanxi Province, No. 13 of Xinmin North Street, Taiyuan, 030001, China. xinli_796@163.com.
Insights
Parental presence during anesthesia induction significantly reduces preoperative anxiety and physiological stress in children undergoing tonsillectomy and adenoidectomy. This approach enhances family satisfaction and is recommended for pediatric surgical care.
Area of Science:
- Pediatric Anesthesiology
- Child Psychology
- Surgical Care
Background:
- Preoperative anxiety is a common concern in pediatric surgical patients.
- Tonsillectomy and adenoidectomy are frequent procedures in children, often associated with anxiety.
- Parental involvement in the perioperative period is increasingly recognized for its potential benefits.
Purpose of the Study:
- To evaluate the impact of parental presence during anesthesia induction (PPIA) on reducing preoperative anxiety in children undergoing tonsillectomy and adenoidectomy.
- To assess the physiological stress responses and compliance during anesthesia induction.
- To compare family satisfaction and anesthesiologist stress levels between groups with and without PPIA.
Main Methods:
- A randomized controlled trial involving 160 children undergoing tonsillectomy and adenoidectomy.
- The trial group included parents during anesthesia induction, while the control group received routine care.
- Anxiety was measured using the Modified Yale Preoperative Anxiety Scale (m-YPAS) and physiological parameters like heart rate and blood pressure were recorded. The Induction Compliance Checklist (ICC) and anesthesiologist stress were also assessed.
Main Results:
- Children in the PPIA group exhibited significantly lower anxiety scores (m-YPAS) and better induction compliance (ICC) compared to the control group.
- Physiological stress markers (heart rate, blood pressure) were reduced in the PPIA group.
- Family satisfaction was higher in the PPIA group, though operation time, costs, and anesthesiologist stress were slightly increased.
Conclusions:
- Parental presence during anesthesia induction is an effective strategy for mitigating preoperative anxiety and physiological stress in pediatric surgical patients.
- PPIA leads to improved patient and family experience, supporting its implementation in routine care.
- While associated with minor increases in operational aspects, the benefits of PPIA outweigh these considerations.
Objective:
To investigate the effect of parental presence during induction of anesthesia (PPIA) in relieving preoperative anxiety of children undergoing tonsillectomy and adenoidectomy.
Methods:
One hundred and sixty children undergoing tonsillectomy and adenoidectomy were divided into the control group and the trial group. The control group received routine nursing in the operation room, while anesthesia was induced in the trial group children in the presence of their parents as part of the routine nursing. The differences in heart rate and mean dynamic pressure during pre-operative visit and anesthesia induction between the two groups were observed and recorded. The Modified Yale Preoperative Anxiety Scale (m-YPAS) and the Induction Compliance Checklist (ICC) were scored. The anxiety status of the children and their family members in the two groups was scored at different times, and the psychological stress of anesthesiologists during anesthesia induction was scored by a visual analogue scale. The differences in each index between the two groups were compared. Operation time and costs in-hospital were also compared.
Results:
Compared with the control group, the heart rate and blood pressure scores as well as the ICC in the trial group were lower than those in the control group (P < 0.01). On comparing the scores of m-YPAS between the two groups, we observed that the scores of the children in the trial group were lower than those in the control group before entering the induction room and anesthesia induction (P < 0.01). There was no statistical difference between the scores of the children in the trial group and the control group on the day of operation and on the way to the operating room (P > 0.05). The nursing satisfaction scores of the family members in the trial group were significantly superior to those in the control group (P < 0.01). The scores of the visual analogue scale for psychological pressure of anesthesiologists during anesthesia induction were higher in the trial group than in the control group (P < 0.05). The operation time and costs in study group were both significantly higher than those of control group (P < 0.05).
Conclusion:
PPIA can significantly reduce preoperative anxiety and surgical physiological stress response in children undergoing tonsillectomy and adenoidectomy, and it is worth being encouraged.
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