At Children's Hospital Boston, we allow a parent to be present at the start of anesthesia when the anesthesiologist considers it to be beneficial for the child. This is called a Parent Present Induction (PPI). A formal program in existence since 1989, PPI helps prepare a parent who accompanies his or her child during the start of anesthesia.
There are a variety of medications that may be given in the preoperative (Pre-Op) holding area while the child's parent(s) is present. These medications help eliminate the distress of separation at the beginning of anesthesia. When these preoperative medications are inadequate or are not recommended, a parent may go with a child into the operating room for the start of anesthesia.
The decision to offer a PPI is individualized, and is made by evaluating factors like the child's age, developmental stage, emotional status, degree of anxiety and willingness to cooperate. Children less than 1 year of age do not usually require parental presence.
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At the time of the preoperative evaluation, the anesthesiologist makes an assessment of the child and parents to determine their ability to participate in a PPI in the operating room. This decision process is very important as its goal is to prevent an undesirable situation. For example, a parent who is very anxious or frightened may have difficulty providing the psychological support needed during the start of anesthesia.
