Comparison Of The Efficacy Of Virtual, Physical And No Parental Presence In Reduction Of Pre-Operative Anxiety In Paediatric Patients Undergoing General Aanaesthesia - A Randomised Controlled Trial.

It Is Well Documented That Many Children Report Fear And Become Distressed During Anaesthesia Induction. Studies Have Shown That Approximately 50 Percent Of Children Aged 3-12 Had High Level Anxiety At Induction Of Anaesthesia Which Peaked When The Anaesthesia Provider Introduced The Face Mask. Anxiety Induced Stimulation Of Autonomic And Endocrine System, Heart Rate, Blood Pressure, Cardiac Contractility, Release Of Catecholamines Can Interfere With The Process Of Smooth Induction. Elevated Anxiety Has Also Been Linked To Increased Post Surgical Pain Perception, Distress, Post Operative Agitation, Delirium And Persistent Adverse Behavioural Patterns After Discharge. Children Aged 2-7 Years Are More Likely To Experience Fear And Separation Anxiety Of Being Separated From Parents.Various Methodologies Have Been Studied To Reduce A Child’s Anxiety. Pharmacological Measures Like Premedication With Benzodiazepines And Non Pharmacological Measures Like Virtual Reality, Musical Interventions, Parental Presence In Operating Room Have Been Employed. Physical Parental Presence Is A Debatable Topic. A Distressed Parent May Worsen A Child’s Anxiety Whereas The Presence Of A Caregiver May Significantly Reduce Anxiety In An Impressionable Young Child. Virtual Parental Presence Is A Relatively Newer Modality Allowing Caregivers To Be Present At The Time Of Induction. The Aim Of This Study Is To Compare The Effect Of Physical, Virtual And No Parental Presence, In Addition To Standard Care, On Pre Operative Anxiety Of Paediatric Patients Aged 3-8 Years Undergoing Induction With General Anaesthesia.