Effects of Different Transport Methods on Preoperative Anxiety and Fear in Preschool Children

Preoperative anxiety is frequently observed in preschool children undergoing surgical procedures. The unfamiliar hospital environment, separation from parents, and fear of anesthesia and surgery may increase children's anxiety and fear before surgery. Elevated preoperative anxiety has been associated with poor cooperation during anesthesia induction, increased postoperative pain, maladaptive behavioral changes, and delayed recovery.

Several non-pharmacological interventions have been developed to reduce children's anxiety before surgery. Among these, distraction techniques and child-friendly environmental modifications have shown promising results. Transporting children to the operating room using battery-powered ride-on cars has recently emerged as an innovative distraction strategy that may transform the transport process into a playful experience.

This controlled study aims to compare three different operating room transport methods in preschool children undergoing elective day surgery: routine transport by walking with a parent, transport by stretcher, and transport using a battery-powered ride-on car. Preoperative anxiety and fear will be assessed using validated pediatric assessment tools before surgery. The study findings may provide evidence for the effectiveness of child-friendly transport methods in reducing preoperative anxiety and fear and support the implementation of non-pharmacological interventions in pediatric surgical care.

Inclusion criteria

• Children aged 3-6 years (36-72 months). Scheduled to undergo elective surgery in the Department of Pediatric Surgery. Able to communicate appropriately for their age. Have sufficient cognitive development to respond to the study assessment scales.

Child and parent/legal guardian are able to speak and understand Turkish. Written informed consent obtained from the child's legal guardian (and child assent obtained when appropriate).

Exclusion criteria

• Presence of visual, hearing, or communication impairments that could interfere with study participation.

Receipt of premedication requiring sedation due to an emergency condition. Presence of severe pain that could affect anxiety assessment before surgery. Inability to safely use the battery-powered ride-on car because of physical or mobility limitations before surgery.

Withdrawal of consent by the child's legal guardian or the child's unwillingness to continue participation.