Family presence in post-anesthesia care unit reduces negative postoperative behavioral changes in preschool children: a randomized controlled trial.

To evaluate the effect of family presence during the post-anesthesia recovery period on the incidence of negative postoperative behavioral changes (NPOBCs) in preschool-aged children, and to provide evidence for the clinical implementation of family accompaniment programs. A randomized controlled trial was conducted between December 2023 and April 2024, enrolling 132 children undergoing general anesthesia. Participants were randomly divided into an experimental group (family accompaniment + standard care) or a control group (standard care alone). Data collection included vital signs (heart rate, respiratory rate, blood pressure, peripheral oxygen saturation (SpO2)), awakening duration, and emotional state assessed using a 5-point Likert scale. Behavioral changes were evaluated at 1, 7, and 14 days post-surgery using the Post Hospitalization Behavior Questionnaire (PHBQ). Compared with controls, the experimental group showed significantly lower heart rate, respiratory rate, and blood pressure (P<0.05). Emotional state scores were also superior in the experimental group (P<0.001). No significant difference was observed in SpO2. The incidence of NPOBCs was comparable on day 1 (P=0.054), but significantly lower in the experimental group on days 7 and 14 (P<0.001). On day 1, the experimental group exhibited reduced sleep anxiety (P=0.034); on day 7, the incidence of overall anxiety, separation anxiety, sleep anxiety and emotional withdrawal decreased significantly (P<0.05); on day 14, the incidence of overall anxiety, separation anxiety, and emotional withdrawal remained significantly lower in the experimental group (P<0.05). Sedation was required in 3 cases in the experimental group versus 32 cases in the control group (P<0.001). No differences were found in analgesic use or awakening duration between the two groups (P>0.05). Family presence during post-anesthesia recovery stabilizes physiological parameters, enhances emotional well-being, and reduces mid- to late-term postoperative behavioral changes in preschool children, supporting clinical implementation of family accompaniment programs.