The Impact of the Presence of Both Parents on Perioperative Anxiety in Children Undergoing Adenotonsillectomy Surgery: A Randomized Clinical Trial.

Abstract

Parental presence has been the topic of various studies to reduce perioperative anxiety, and it has been demonstrated that the selection of the accompanying parent decreases perioperative anxiety. Nevertheless, the selection process may be another challenging factor for the child during the preoperative period. Therefore, the aim of this study was to demonstrate that the presence of both parents during the preoperative period would be more appropriate in respect of not adding to anxiety, which can be created by a selection process. The research included 80 children, aged 5-12 years, from both genders, undergoing elective day-case surgery for otolaryngological procedures. The participants were divided randomly into two groups of 40. In Group 1, children selected one parent to accompany them during the perioperative period, while in Group 2, both parents were present with the child. The modified Yale Preoperative Anxiety Scale (mYPAS) was used to assess the anxiety levels of the children. The Pediatric Anesthesia Emergence Delirium (PAED) scale was utilized to evaluate postoperative delirium. The evaluation of parents' anxiety was conducted using the State-Trait Anxiety Inventory (STAI). The mean mYPAS scores for Group 2 were lower than those of Group 1 in the preoperative waiting area and during anesthesia induction (mean difference [95% CI]: 5.8 [-4.5 to 13.5]; 7.5 [0.0 to 15.0], respectively). The mean PAED scores were similar in both groups (mean difference [95% CI]: -1.5 [-4.5 to 1.5]). The incidence of emergence delirium and the mean STAI anxiety scores of the parents were similar in both groups. This study demonstrated that the presence of both parents reduced the anxiety of the child in both the preoperative period and during anesthesia induction. Moreover, this practice did not create any change in the incidence of emergence delirium, for which there are many risk factors besides preoperative anxiety. Children's preoperative anxiety in the operating room can be mitigated through different means. In this study, presence of both parents was compared to presence of one parent only, for anxiety scoring for the child. Findings showed benefit of having two parents present in this cohort. ClinicalTrials.gov: NCT06634680.