Parental Presence during Induction of Anesthesia and Emergence Delirium Influence the Incidence of Postoperative Maladaptive Behavioral Changes

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Key takeaways

• Parental presence during anesthesia induction significantly reduces postoperative maladaptive behavioral changes in children versus no intervention or midazolam alone.
• Higher emergence delirium scores (PAED scale) independently predict increased risk of long-term postoperative behavioral problems.
• Benefits of parental presence are most pronounced in children under 5 years of age during the first week and month post-surgery.
• Midazolam premedication alone does not reduce behavioral changes; parental presence is the key protective factor.
• Postoperative behavioral changes can persist for months after discharge, making perioperative psychological preparation clinically important.

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