Gamified breathing exercises before surgery to reduce anxiety and emergence delirium in children

Preoperative Anxiety and Postoperative Recovery Delirium Observation in Children Who Underwent Gamified Breathing Exercise

This trial will test whether fun, game-like breathing exercises done before surgery reduce preoperative anxiety and emergence delirium in children aged 3–7.

Quick facts

• Phase: NA
• Study type: Interventional
• Enrollment: 80 (estimated)
• Ages: 3 Years to 7 Years
• Sex: All
• Sponsor: Bozok University (other)
• Locations: 1 site (Bursa, Bursa)
• Trial ID: NCT07408037 on ClinicalTrials.gov

What this trial studies

This is a randomized controlled trial in which children aged 3–7 scheduled for elective surgery are assigned to either a gamified breathing-exercise program or routine preoperative care. The intervention group and their parents receive training 48–72 hours before surgery and practice selected breathing games (ball blowing, bubble blowing, paper/tissue blowing, candle blowing) repeatedly until surgery. Exercises are performed roughly 10 minutes each hour, about 10–15 times per day, and games are chosen based on the child's preference to encourage engagement. Preoperative anxiety is measured with the Modified Yale Preoperative Anxiety Scale (mYPAS-SF) and emergence delirium is measured with the PAED scale at 0, 15, and 30 minutes in the recovery room.

Who should consider this trial

Good fit: Children aged 3 to 7 years who are ASA I–II, scheduled for elective surgery at the study hospital, and whose parents can attend training and provide informed consent are eligible.

Not a fit: Children with chronic neurological or psychiatric disorders, respiratory conditions that prevent breathing exercises, significant communication barriers, or those undergoing emergency surgery are unlikely to benefit from this intervention.

Why it matters

Potential benefit: If successful, this low‑risk, nonpharmacologic approach could lower preoperative anxiety and reduce the frequency or severity of emergence delirium and related postoperative complications in preschool children.

How similar studies have performed: Prior pediatric studies of distraction, breathing exercises, and behavioral interventions have shown reductions in preoperative anxiety and some improvements in emergence outcomes, but dedicated gamified preoperative breathing programs are a relatively novel and less‑studied approach.

Eligibility criteria

Inclusion Criteria:

* Children aged 3 to 7 years (preschool age).

Scheduled for elective (planned) surgery at Bursa Uludag University Hospital.

Physical status classified as ASA I or ASA II.

Children and parents who volunteer to participate and provide written informed consent.

Exclusion Criteria:

Children with chronic neurological or psychiatric disorders.

Children with existing respiratory system diseases that prevent breathing exercises.

Children or parents with communication barriers (e.g., severe hearing or speech impairment).

Children undergoing emergency (non-elective) surgery.

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Where this trial is running

Bursa, Bursa

• Bursa Uludağ Üniversitesi Hastanesi — Bursa, Bursa, Turkey (Türkiye) (RECRUITING)

Study contacts

• Study coordinator: Gulay ÖZTAŞ, PhD

Conditions: Preoperative Anxiety, Emergence Delirium, Postoperative Complications, Pediatric Patients, Gamification, Breathing Exercises, Pediatric Nursing, Postoperative Recovery