Predicting which children benefit most from parental presence during induction of anesthesia

Background: The purpose of this large-scale prospective cohort study (n = 426) was to identify child and parent characteristics that are associated with low anxiety and good compliance during induction of anesthesia when parents are present. Methods: Outcome variables included child's anxiety and child's compliance during induction of anesthesia. Predictor variables included demographics, temperament, trait (baseline) anxiety, coping style, and locus of control. Results: Results of a linear regression model (overall proportion of variance accounted for equals 39.5%) showed that significant predictors of anxiety during induction of anesthesia while parents are present included: the child's age (Delta R-2 = 0.315, P = 0.0001), behavior during previous medical visits (Delta R-2 = 0.025, P = 0.001), child's activity level (Delta R-2 = 0.016, P = 0.007), parent's state (contextual) anxiety (Delta R-2 = 0.022, P = 0.001) and parent's locus of control (Delta R-2 = 0.009, P = 0.036). A linear regression model that was constructed with compliance of the child as the outcome revealed similar findings. Conclusions: Children who benefit from parental presence are older, had lower levels of activity in their temperament, and had parents who were calmer and who valued preparation and coping skills for medical situations. The practical implications of these findings are discussed.