Parents’ presence in the recovery room may reduce children’s behavior problems

All parents worry when their child is undergoing surgery and anesthesia. You might assume that children undergoing surgery would be much relieved to find Mom or Dad is there when they wake up—but that's not necessarily the case, according to a study in the April issue of Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS).

However, over the next few weeks, children whose parents were present in the recovery room have fewer behavior problems, according to the study by Dr David B. Lardner and colleagues of Alberta Children's Hospital at the University of Calgary. "For children coming for day surgery, unwanted behavior changes can occur even after leaving the hospital," says Dr. Lardner. "The simple act of having a parent in the recovery room just after the child wakes can have lasting benefits and decrease these behavior problems."

Having Parents Present Doesn't Reduce Crying, but May Improve Children's Adjustment

The study included 300 children, aged two to eight, undergoing outpatient surgery (no hospital stay). One group of children was randomly assigned to have a parent present in the postanesthesia care unit (PACU, or recovery room) after surgery. In the other group, parents weren't present. Both groups of parents underwent a brief preparation program.

Having parents present did not affect the children's level of distress in the recovery room. Children spent just as much time crying when their parents were present as when they were absent. In both groups, the children were crying or disoriented about 30 percent of the time.

Unexpectedly, however, having parents present seemed to affect the children's behavior in the weeks after surgery. Based on a questionnaire considered valid for assessing children's behavior after surgery, nearly half of the children (46 percent) whose parents were not with them in the recovery room had negative behaviors in the two weeks following surgery. When parents were present, the rate of behavior problems was reduced to a little less than one-third (29 percent).

In children undergoing surgery, anxiety has been linked to increased pain, sleep disturbances, and other behavioral problems. Different types of preparation programs have been tested in an attempt to reduce children's anxiety before surgery, in the hope of reducing pain and other postoperative problems.

The new study is one of the first to examine the effects of having parents present in the PACU—which is routine practice at many hospitals. "Even though the child may not show any immediate response to the presence of a parent, having a parent around when waking up from surgery seems to have a lasting benefit," comments Dr. Steven Shafer of Columbia University, Editor-in-Chief of Anesthesia & Analgesia. "That won't come as a surprise to most parents, particularly those whose children have required several operations at a young age."