Parental Presence And Intranasal Dexmedetomidine Effect The Anxiety Level Of Children Undergoing General Anesthesia

Objective : The study was designed to evaluate the preoperative anxiety ? induction compliance and emergence delirium of children?anxiety and satisfaction of parent with parental presence at induction of anesthesia(PPIA)?intranasal dexmedetomidine(DEX)and combination usage of PPIA and intranasal DEX.Methods : In this prospective study,a total of 124 children scheduled for ENT surgery(tonsillectomy and/or adenoidectomy)with general anesthesia were randomly divided into four groups :Control group(C group): no parental presence at induction of anesthesia.PPIA group(P group): parental presence at induction of anesthesia.DEX group(D group):intranasal DEX(1.0?g/kg)and no parental presence at induction of anesthesia.PPIA +DEX group(PD group): intranasal DEX(1.0?g/kg)and parental presence at induction of anesthesia.Anxiety of the children was evaluated with the modified Yale Preoperative Anxiety Scale-Short Form(m YPAS-SF)and the Induction Compliance Checklist(ICC)was used to evaluate the compliance of children at the induction of anesthesia,the Pediatric Anesthesia Emergence Delirium Scale(PAED)was used to evaluate emergence delirium of the children.The state-trait anxiety inventory(STAI)was completed by the parents regarding their own anxiety level.The Visual Analog Scale(VAS)was employed to assess the satisfaction of parents.Results : At either T0 or T1,there were no significant difference in m YPAS-SF scores among the four groups(P > 0.05).At T2,the m YPAS-SF scores of P group,D group and PD group were significantly lower than m YPAS-SF score of C group(P < 0.001).The m YPAS-SF score of P group was significantly lower than m YPAS-SF score of group DEX(P=0.008).The m YPAS-SF score of the PD group was significantly lower than score of P group and D group(PD group vs P group P=0.004,PD group vs D group P <0.001);.The ICC scores of P group,D group and PD group were significantly higher than score of C group(P <0.001).The ICC score of the PD group was significantly higher than scores of P group and D group(PD group vs P group P =0.001,PD group vs D group P < 0.001);At T0,there was no statistically significant difference in STAI-T scores among the different groups.(P>0.05).At T2,the STAI-S scores of P group,D group,and PD group were significantly lower than score of C group(P < 0.05),There was no statistically significant difference among P group,D group,and PD group.The VAS scores of P group,D group,and PD group were significantly higher than score of Control group(P < 0.05),and the score of PD group was significantly higher than those of P group and D group(PD group vs P group P<0.05,PD group vs D group P<0.05).At T3,The children's PAED scores of P group,D group,and PD group were all significantly lower than the PAED score of C group(P<0.05),There were no statistical differences among P group,D group,and PD group(P>0.05).Conclusions : Both PPIA and intranasal DEX may alleviate preoperative anxiety of children and parents,children's emergence delirium,and improve parental satisfaction and children's induction compliance.The combination usage of PPIA and intranasal DEX is more effective than either PPIA or intranasal DEX for alleviating preoperative anxiety of children,improving children's induction compliance and parental satisfaction.