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NCT Number: NCT07151131

Cartoons and Reflexology for Postoperative Nausea, Pain, and Anxiety in Children

Preoperative anxiety arises as a physiological response of the body to stressors and is pathophysiologically associated with stimulation of the autonomic nervous system and increased catecholamine release (Durgut, 2021). As a result, elevated levels of cortisol and epinephrine in the body can cause cytotoxic effects at the cellular level. This physiological mechanism may lead to hypertension, arrhythmia, tachycardia, and tachypnea in children (Dehghan et al., 2019; Durgut, 2021).

Due to these effects, recent evidence-based studies have focused on the use of non-pharmacological approaches with fewer side effects to manage anxiety in children (Kavak et al., 2019). According to the literature, various techniques have been identified as effective interventions for reducing preoperative anxiety in children, including:

Listening to music,

Playing games,

Using dramatic puppets,

Interactive play,

Virtual reality applications,

Watching cartoons,

Playing favorite video games,

Video presentations,

Hospital clowns,

Storybooks,

Visual and auditory stimuli

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Key information

Conditions

Children Agnosia Nausea Nausea, Postoperative Nervous System Diseases Neurobehavioral Manifestations Neurologic Manifestations Pain Management Pathologic Processes Pathological Conditions, Signs and Symptoms Perceptual Disorders Postoperative Complications Postoperative Nausea and Vomiting Signs and Symptoms Signs and Symptoms, Digestive Vomiting

Age range

4 year–6 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Participants were included in the study if they met all of the following conditions:

The child was hospitalized in the pediatric surgical clinic for a planned (elective) surgery,

The child was aged between 4 and 6 years,

The child was scheduled to receive general anesthesia,

Neither the child nor the primary caregiver had any visual, hearing, or cognitive impairments,

The child had no anatomical abnormalities or tissue integrity issues in the feet,

Verbal assent was obtained from the child,

Both parents provided written and verbal informed consent for participation,

Both the child and parents were willing and voluntarily agreed to participate in the study.

Exclusion criteria

Participants were excluded from the study if any of the following conditions occurred:

Postoperative bleeding tendency developed in the child,

The child required postoperative intensive care,

A high-risk complication developed after surgery,

The child failed to initiate spontaneous respiration postoperatively,

Intraoperative death (exitus) occurred,

The child experienced prolonged unconsciousness due to anesthesia,

The child underwent surgical procedures involving the feet.

Treatment and study plan

Watching Cartoons

Other

Cartoon Group Intervention Children assigned to the cartoon group will be taken from the clinic to the preoperative room. Approximately 30 minutes before being transferred to the operating room, children will be allowed to watch a cartoon of their choice on a 60-inch screen TV placed approximately 200 cm away. The duration of the cartoon viewing session will be limited to 20 minutes.

The measurement tools used in the study will be administered at five different time points:

Immediately before watching the cartoon,

Immediately after watching the cartoon but before being transferred to the operating room,

In the postoperative period at the 60th minute,

At the 120th minute postoperatively,

And finally, at the discharge phase.

Reflexology

Other

Massage Group Intervention Children assigned to the massage group will be transferred from the clinic to the preoperative room. Approximately 30 minutes before being taken to the operating room, reflexology massage will be applied by the researcher physician Xxx XXXXX, who holds a valid reflexology certification. The massage will be administered to both the right and left feet, with 10 minutes per foot, for a total duration of 20 minutes.

The measurement tools used in the study will be applied at five distinct time points:

Before the massage,

Immediately after the massage but before operating room transfer,

In the postoperative period at the 60th minute,

At the 120th minute postoperatively,

And finally, during the discharge phase.

Primary outcomes

Anxiety Tool: Preoperative Anxiety Scale

Time frame: Baseline, Postoperative 60th and 120th minutes
Pain Tool: Wong-Baker FACES Pain Rating Scale

Time frame: Postoperative 60th and 120th minutes
Nausea Tool: standardized observational nausea scale

Time frame: Postoperative 60th and 120th minutes

Study contacts

Contact information is provided by the study sponsor or research team.

Öznur Tiryaki, Asoss.Prof.

CONTACT

[email protected]

+90264 295 7271

Sponsors and collaborators

Lead sponsor

Sakarya University

Other

Registry information

Important dates

Study start: 2025
Primary completion: 2025
Study completion: 2025
First posted: Sep 3, 2025
Registry last updated: Sep 3, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed