A META-ANALYSIS OF PARENTAL PRESENCE AT ANAESTHESIA INDUCTION ON POST-OPERATIVE BEHAVIOURAL OUTCOMES IN YOUNG CHILDREN: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.71000/7bmrkz67Keywords:
Anesthesia Induction, Anxiety, Child Behaviour Disorders, Emergence Delirium, Family-Centered Care, Meta-Analysis, Paediatric Anaesthesiology.Abstract
Background: Emergence delirium and postoperative behavioural disturbances are among the most distressing complications in paediatric anaesthesia. Parental presence during anaesthesia induction has been proposed as a non-pharmacological strategy to alleviate perioperative anxiety and improve postoperative outcomes, yet evidence regarding its effectiveness on behavioural endpoints remains inconsistent.
Objective: To quantitatively synthesize evidence on the effect of parental presence during anaesthesia induction on emergence delirium and negative postoperative behavioural changes in young children.
Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. Electronic databases including PubMed, Cochrane Library, Embase, and Scopus were searched up to December 2025 for randomized and quasi-randomized controlled trials comparing parental presence with standard care or other interventions. Studies enrolling children aged 1–12 years undergoing elective surgery under general anaesthesia were included. Outcomes were measured using validated scales: the Pediatric Anesthesia Emergence Delirium (PAED) scale and the Post-Hospital Behaviour Questionnaire (PHBQ). Data were pooled using a random-effects model, and heterogeneity was assessed with the I² statistic.
Results: Ten studies involving 1,200 participants were included. The pooled analysis showed a significant reduction in mean PAED scores (mean difference −2.85, 95% CI −4.10 to −1.61, p < 0.001) and in the risk of emergence delirium (RR 0.52, 95% CI 0.38–0.73). Negative behavioural changes were also significantly lower (RR 0.58, 95% CI 0.45–0.74). Subgroup analysis demonstrated a stronger effect among children undergoing ENT surgeries. No significant publication bias was detected (Egger’s p = 0.21).
Conclusion: Parental presence during anaesthesia induction significantly reduces emergence delirium and negative postoperative behavioural changes in children. This evidence supports the incorporation of family-centred perioperative practices in paediatric anaesthesiology to enhance recovery and emotional wellbeing.
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Copyright (c) 2025 Zarina Naz, Ishrat Mahtam, Beenish Naseem, Mamoona Shaikh, Shahbaz Ahmad, Akif Saeed Ch (Author)
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