A tablet-based augmented reality system to reduce preoperative anxiety in pediatric patients: a quasi-experimental pilot study.

Preoperative anxiety in pediatric patients remains a significant clinical challenge, yet existing interventions are limited by resource requirements and inconsistent effectiveness. The aim of this pilot study was to evaluate the feasibility and preliminary effects of a tablet-based augmented reality (AR) system integrated into routine perioperative patient transfer on preoperative anxiety in pediatric patients. In this single-center, quasi-experimental pilot study, 27 pediatric patients aged 3-10 years were assigned to an AR (n = 13) or control (n = 14) group based on surgery month. The AR system, implemented on a standard tablet device, overlaid virtual characters onto real-world surroundings to guide patients from the surgical center entrance to the operating room. The primary outcome was preoperative anxiety assessed using the modified Yale Preoperative Anxiety Scale (mYPAS) at operating room entry. Secondary outcomes included guardian-rated comfort visual analog scale scores and postoperative agitation. The AR group was younger than the control group. Median mYPAS scores at operating room entry were lower in the AR group than in the control group (28.3 [23.3-36.7] vs. 40.0 [36.7-52.9]; median difference - 11.7; 95% CI, - 18.4 to - 1.60; p = 0.01). No significant differences were observed in secondary outcomes. This pilot study demonstrates the feasibility of integrating a tablet-based AR system into perioperative workflows. Preliminary findings also indicate that this approach may help reduce preoperative anxiety in this population. Given the pilot nature of the study, non-randomized allocation, and baseline imbalances between groups, validation in larger, well-controlled, randomized trials is required.