The Effect of Preoperative Child and Parental Anxiety on Emergence Agitation and Postoperative Pain in Children Undergoing Adenoidectomy and Tonsillectomy: A Prospective Observational Study


Gemici D., Karakaya D., Dost B., Barış S.

Journal of Perianesthesia Nursing, 2026 (SCI-Expanded, SSCI, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1016/j.jopan.2026.04.011
  • Dergi Adı: Journal of Perianesthesia Nursing
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus, CINAHL, EMBASE, MEDLINE
  • Anahtar Kelimeler: adenoidectomy, emergence agitation, parental anxiety, postoperative pain, preoperative anxiety, tonsillectomy
  • Ondokuz Mayıs Üniversitesi Adresli: Evet

Özet

Purpose Emergence agitation (EA) is a frequent postoperative behavioral disturbance in children undergoing adenoid and tonsillar surgery and may be influenced by preoperative anxiety. This study aimed to examine the relationship between preoperative parental anxiety and EA, and to explore associations among parental anxiety, child anxiety, and postoperative pain. Design A single-center, prospective observational study conducted at Ondokuz Mayıs University between March and October 2024. Methods Ninety-nine children aged 3 to 7 years who underwent adenoidectomy, tonsillectomy, or adenotonsillectomy and their parents were included. Parental anxiety was measured with the State-Trait Anxiety Inventory, and children’s anxiety with the modified Yale Preoperative Anxiety Scale. EA was evaluated using the Watcha Behavior Scale at 1, 10, 20, and 30 minutes postoperatively, and pain with the Wong–Baker FACES Pain Rating Scale. Findings EA occurred in 25% of children, without sex-based differences. Parental State-Trait Anxiety Inventory scores were not correlated with EA (P ≥ .05). Child preoperative anxiety correlated weakly but significantly with EA at 10 to 30 minutes (r = 0.288 to 0.335, P < .01). Parental trait anxiety correlated weakly with child anxiety (r = 0.198, P = .049) and moderately with postoperative pain at 20 minutes and 24 hours (r = 0.585 and 0.502, P < .001). Conclusions Preoperative parental anxiety was not directly associated with EA; however, higher parental trait anxiety was linked to greater child preoperative anxiety and increased postoperative pain. Managing parental anxiety before pediatric adenoid and tonsillar surgery may improve perioperative emotional stability and recovery outcomes.