Effect of Daily Screen Time on Postoperative Emergence Delirium in Children Aged 2-11 Years

This prospective observational study aims to evaluate the association between daily screen exposure duration and postoperative emergence delirium in children aged 2 to 11 years undergoing elective lower abdominal surgery. Daily screen time will be assessed using a parent-reported questionnaire administered preoperatively. Postoperative emergence delirium will be evaluated using the Pediatric Anesthesia Emergence Delirium (PAED) scale at 5, 10, 15, and 30 minutes after surgery. The primary outcome is the association between daily screen time and PAED score within the first 30 minutes postoperatively. Secondary outcomes include the associations between PAED score and age at first screen exposure, type of viewed content, parental screen use, passive screen exposure, and the presence of a screen in the child's bedroom. The study is designed to improve understanding of whether screen-related environmental factors are associated with postoperative behavioral recovery in pediatric surgical patients.

Inclusion Criteria: * Children aged 2 to 11 years * Scheduled for elective lower abdominal surgery * Planned procedures include inguinal hernia repair, orchiopexy for undescended testis, or circumcision * American Society of Anesthesiologists (ASA) physical status I-II * Parent or legal guardian able to provide written informed consent * Parent or legal guardian able to complete the study questionnaire Exclusion Criteria: * Planned or administered premedication before surgery * Emergency surgery * Reoperation * Developmental delay, neurodevelopmental disorder, or known psychiatric disease * Visual or hearing impairment that may interfere with behavioral assessment * Current use of sedative, antipsychotic, or antiepileptic medication * Anticipated postoperative intensive care unit requirement * Incomplete or unreliable parent-reported questionnaire data