IMPLICATIONS: Parental presence reduces children’s anxiety during induction of anesthesia depending on the interaction between child and parent’s baseline anxiety.

Several randomized controlled trials indicate that parental presence during induction of anesthesia (PPIA) does not reduce child anxiety (1–4). Many clinicians believe, however, that randomized control trials do not reflect actual clinical practice and that the impact of PPIA also depends on variables such as the interaction between parental anxiety and the child’s anxiety. That is, children who are calm and whose parents are overly anxious may respond differently to PPIA as compared to anxious children with calm parents, calm children with calm parents, or anxious children with overly anxious parents.