Role of Preoperative Anxiety in Pediatric Anesthesia Outcomes

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@article{1718869,
      author = {Kouser Banu Khaleeluddin},
      title = {Role of Preoperative Anxiety in Pediatric Anesthesia Outcomes},
      journal = {Iconic Research And Engineering Journals},
      year = {2026},
      volume = {9},
      number = {12},
      pages = {2772-2782},
      issn = {2456-8880},
      url = {https://www.irejournals.com/formatedpaper/1718869.pdf},
      abstract = {Preoperative anxiety is a frequent and clinically meaningful exposure in paediatric anaesthesia. It arises from developmental vulnerability, separation from caregivers, uncertain sensory cues, previous medical experience, parental distress, and the perceived threat of pain or loss of control. Recent studies report high rates of anxiety in children presenting for surgery, with the most intense responses often occurring during transfer to theatre and anaesthesia induction. This review examines how preoperative anxiety contributes to anaesthesia outcomes in children, with particular attention to induction compliance, emergence delirium, postoperative pain, maladaptive behaviour, parental experience, and perioperative efficiency. A structured literature review of publications from 2020 to 2025 was undertaken across major biomedical databases, prioritising clinical trials, observational studies, systematic reviews, and practice-focused evidence relevant to children undergoing procedures under general anaesthesia. The literature indicates that preoperative anxiety is not merely an emotional state but a modifiable perioperative risk factor. Younger age, parental anxiety, low sociability, negative previous hospitalisation, language barriers, and surgical setting repeatedly appear as risk signals. Anxiety may worsen cooperation during induction, intensify physiological stress, increase postoperative pain reporting, and contribute to emergence delirium and behavioural disturbance. However, the strength of association varies by measurement timing, surgical type, analgesic strategy, and family preparation. Evidence favours early identification and proportionate intervention using developmentally tailored education, parental coaching, play-based preparation, audiovisual distraction, virtual reality, mask rehearsal, environmental control, and selected pharmacological anxiolysis. High-quality care requires an integrated pathway rather than reliance on one technique. This review proposes an outcome-focused preventive care bundle that links anxiety screening with practical perioperative actions and recovery metrics. Embedding anxiety management within routine paediatric anaesthesia may improve safety, experience, and recovery while reducing avoidable distress.},
      keywords = {Paediatric Anaesthesia, Preoperative Anxiety, Emergence Delirium, Postoperative Pain, Induction Compliance, Perioperative Outcomes},
      month = {June},
      doi = {https://doi.org/10.64388/IREV9I12-1718869}
  }