Evaluation of the Effects of Ride-On Toy Car Use During Operating Room Transfer on Preoperative Anxiety and Postoperative Delirium in Preschool Children
Conditions: Preoperative Anxiety, Emergence Delirium in Pediatric Anesthesia
Sponsor: Ankara City Hospital Bilkent

 
 
 
Evaluation of the Effects of Ride-On Toy Car 
Use During Operating Room Transfer on 
Preoperative Anxiety and Postoperative 
Delirium in Preschool Children 
 
   
 
 
 
 
 
 
 
Document Type: Study Protocol 
Ethics Committee Approval Date: 22 October 2025 

Brief Description 
This study aims to evaluate preoperative anxiety levels and postoperative emergence 
delirium in pediatric patients undergoing elective adenoidectomy and/or tonsillectomy. 
Children are transferred to the operating room either using a ride-on toy car or a standard 
hospital stretcher. Preoperative anxiety and postoperative delirium are assessed using 
validated pediatric assessment tools during the perioperative period. 
Study Design 
This study is designed as a prospective observational study. 
Study Population 
Male children aged 3–7 years scheduled for elective adenoidectomy and/or tonsillectomy 
under general anesthesia. 
Eligibility Criteria 
Inclusion Criteria: 
- Male patients aged 3–7 years 
- ASA physical status I–II 
- Scheduled for elective adenoidectomy and/or tonsillectomy 
- Parental consent obtained 
 
Exclusion Criteria: 
- History of psychiatric, neurological, genetic, or developmental disorders 
- Previous surgical experience 
- Use of anxiolytic medication outside the study protocol 
Study Procedures 
Participants will be enrolled on the day of surgery. Transfer to the operating room will 
occur either using a ride-on toy car or a standard hospital stretcher, depending on real-time 
availability. 
Outcome Measures 
Preoperative anxiety will be assessed using the Modified Yale Preoperative Anxiety Scale 
(m-YPAS) and Visual Analog Scale for Anxiety (VAS-A). Postoperative emergence 
delirium will be assessed using the Pediatric Anesthesia Emergence Delirium (PAED) 
scale. 
Timing of Assessments 
Preoperative assessments: waiting area, before transfer, during transfer, before anesthesia 
induction. 
Postoperative assessments: immediately after extubation, upon arrival in PACU, and 30 
minutes after PACU admission. 

Statistical Analysis 
Descriptive statistics will be used. Between-group comparisons will be performed using 
appropriate parametric or non-parametric tests based on data distribution. A p-value < 0.05 
will be considered significant. 
Ethics 
The study will be conducted in accordance with the Declaration of Helsinki. Ethics 
committee approval and written informed consent from parents/legal guardians will be 
obtained.