Video Distraction Reduces Anxiety, Pain, and Delirium in Pediatric Tonsillectomy.

PURPOSE: This study examined the effects of preoperative video-assisted distraction on postoperative anxiety, pain on awakening, and emergence delirium during early postanesthetic recovery in children undergoing tonsillectomy. DESIGN: A randomized controlled trial using stratified randomization based on age and sex. METHODS: Children aged 4-9 years were stratified by age and sex and randomly assigned to a distraction group (n = 30) or control group (n = 29). The intervention consisted of an interactive video featuring a hand puppet explaining anesthesia, surgery, and recovery. Outcomes were measured using the FACES Anxiety Scale, a pediatric pain scale, and the Pediatric Anesthesia Emergence Delirium scale. FINDINGS: Significant group-by-time interactions were observed for anxiety and pain scores. At 10 min after post-anesthesia care unit (PACU) admission, children in the intervention group demonstrated lower anxiety and pain scores than those in the control group. Lower pain scores remained evident in the intervention group at 30 min after PACU admission. Although Pediatric Anesthesia Emergence Delirium Scale scores were lower in the intervention group at both postoperative assessment points, the group-by-time interaction for emergence delirium was not statistically significant. CONCLUSIONS: Video-assisted preparation and distraction may be an effective nurse-led, non-pharmacological intervention for reducing postoperative anxiety and pain during early PACU recovery in children undergoing tonsillectomy. Further studies are needed to determine the effects of this intervention on emergence delirium and longer-term recovery outcomes.