Chundamala Josie, Wright James G, Kemp Sheelagh M
Department of Surgery, The Hospital for Sick Children, 555 University Avenue, Room 1218, Black Wing, Toronto, ON, Canada M5G 1X8.
Can J Anaesth. 2009 Jan;56(1):57-70. doi: 10.1007/s12630-008-9008-3. Epub 2008 Dec 20.
The purpose of this evidence-based review was to examine the effect of parental presence during anesthesia induction on parents' and children's anxiety.
MEDLINE (1950 to 2008) and EMBASE (1980 to 2008) were searched. Studies were restricted to randomized controlled trials (RCTs) and comparative studies only (levels of evidence I-III).
Fourteen studies that provided level II or level III evidence were included (nine RCTs, four prospective comparative studies, and one retrospective comparative study). Of the 10 studies that evaluated parents' anxiety, most did not find parental presence to be more effective than no parental presence, midazolam, or parental presence plus midazolam. Of the 11 studies that examined children's anxiety, most did not find parental presence to be more effective than no parental presence, midazolam, parental presence plus midazolam, or parental presence plus a video game.
Contrary to popular belief, in most cases parental presence does not appear to alleviate parents' or children's anxiety. In the rare instances when it does seem to diminish parents' or children's anxiety, premedicating children with midazolam has shown to be a viable alternative. Other anxiety-reducing solutions, such as distracting children with video games, should also be considered.
本循证综述旨在探讨麻醉诱导期间家长陪伴对家长及儿童焦虑的影响。
检索了MEDLINE（1950年至2008年）和EMBASE（1980年至2008年）。研究仅限于随机对照试验（RCT）和比较研究（证据等级I - III）。
纳入了14项提供II级或III级证据的研究（9项RCT、4项前瞻性比较研究和1项回顾性比较研究）。在评估家长焦虑的10项研究中，大多数未发现家长陪伴比无家长陪伴、咪达唑仑或家长陪伴加咪达唑仑更有效。在研究儿童焦虑的11项研究中，大多数未发现家长陪伴比无家长陪伴、咪达唑仑、家长陪伴加咪达唑仑或家长陪伴加电子游戏更有效。
与普遍看法相反，在大多数情况下，家长陪伴似乎并不能减轻家长或儿童的焦虑。在极少数似乎能减轻家长或儿童焦虑的情况下，用咪达唑仑对儿童进行术前用药已被证明是一种可行的选择。还应考虑其他减轻焦虑的方法，如用电子游戏分散儿童注意力。
