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March 6, 2026International Journal of Surgery Open8 citationsOpen Access

Preoperative anxiety in children: prevention and management. A comprehensive review and analysis

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COCham Ojulu OttoHTHailu Yimer TawuyeHAHabtu Adane Aytolign

Key Points

  • The review aims to explore effective prevention and management strategies for preoperative anxiety in child surgical patients.
  • Conducted a systematic review of literature on preoperative anxiety in children.
  • Searched through multiple databases including SCOPUS, PubMed, and Cochrane Library.
  • Utilized Medical Subject Headings (MeSH) and Boolean operators for a refined search.
  • Screened literature using appropriate appraisal checklists.
  • Sedative premedication and parental presence significantly aid in managing anxiety.
  • Effective interventions include educational videos, games, and clown interactions.
  • Distraction techniques such as deep breathing exercises and toys notably reduce anxiety during stressful situations.

Abstract

Background: Preoperative anxiety frequently occurs among children. It has both immediate and enduring impacts on their growth, development, overall health, and postsurgical outcomes. Preventing and managing preoperative anxiety in children can reduce the occurrence of detrimental behaviors after surgery. This review aimed to investigate strategies for both preventing and managing preoperative anxiety in child surgical patients. Methods: Following the methodology employed for the systematic review, pertinent literature was sought from various databases and other sources. Recent evidence was identified using the following databases: SCOPUS, PubMed, Science Direct, Google Scholar, Cochrane Library, MEDLINE, and Embase. To refine the search and gather relevant supporting evidence, Medical Subject Headings (MeSH) were utilized alongside proximity and Boolean operators such as OR, AND, and NOT. Duplicate entries were removed using EndNote software, and a thorough screening of the literature was conducted using appropriate appraisal checklists. Results: Using sedative premedication, parental presence during anesthesia induction, and behavioral interventions are key components of anxiety management. Furthermore, case-specific preoperative interviews, educational videos, games, clown interactions, and virtual tours can all be effective if implemented appropriately. Distraction techniques such as deep breathing exercises, videos, or toys are highly effective, especially during stressful moments. Conclusions and recommendation: Controlling preoperative anxiety in children poses a significant challenge for anesthesiologists, and addressing anxiety is a crucial aspect of pre-anesthesia consultations and checkups. Therefore, assessing, prevention, and management of preoperative anxiety in children is crucial for smooth induction and better postoperative outcome.

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Cite This Study

Otto et al. (2025) studied this question.

synapsesocial.com/papers/69aa6eb1531e4c4a9ff58deahttps://doi.org/10.1097/io9.0000000000000262
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