Potential antioxidant effects of 3D film prepared for anxiety management in pediatric surgery clinics

Emel Demir; Vesile Duzguner; Ahmet Atici; Erhan Yengil

doi:10.17944/interdiscip.1825399

Potential antioxidant effects of 3D film prepared for anxiety management in pediatric surgery clinics

Abstract

Objective: This randomized controlled study examined the potential antioxidant effects of a three-dimensional (3D) film prepared for anxiety management in children hospitalized in pediatric surgery clinics. The study aimed to determine whether virtual reality (VR)-based distraction could influence oxidative stress markers associated with preoperative anxiety. Method: 50 children aged 5–12 years were randomly assigned to either a VR group or a control group. After exclusions due to insufficient or hemolyzed samples, 38 participants (18 VR, 20 control) were included in the final analysis. The VR group watched a 3D hospital-themed film using VR goggles before intravenous cannulation. Blood samples taken before and after the intervention were analyzed for total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), glutathione (GSH), and cortisol levels. Results: Compared with the control group, the VR group showed significantly lower TOS, OSI, and cortisol levels, and higher TAS and GSH levels (p < 0.001). These results indicate that VR exposure reduced oxidative stress and helped maintain antioxidant balance. Conclusion: The use of 3D VR films prior to minor surgical procedures has been associated with reduced biochemical stress markers in children. In addition to potential psychological benefits, VR intervention resulted in measurable biochemical improvements. These findings suggest that the method could be used as an adjunct non-pharmacological approach in pediatric surgical settings.

Keywords

Supporting Institution

No financial support was received for this article.

Ethical Statement

This study was approved by Hatay Mustafa Kemal University Tayfur Ata Sökmen Faculty of Medicine ethics committee (02.07.2025-N0:5). Children and their mothers were informed about the purpose of the study. Verbal and written consent was obtained from the mothers who agreed to participate. The Helsinki Declaration rules were followed to conduct this study.

References

Weinberger DR. Anxiety at the frontier of molecular medicine. New Engl J Med. 2001;344(16):1247-9. https://doi.org/10.1056/NEJM200104193441612
APA. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington DC: Amerikan Psikiyatri Birliği; 2000.
Gomes GLL, Fernandes MDM, da Nobrega MML. Hospitalization anxiety in children: conceptual analysis. Rev Bras Enferm. 2016;69(5):884-9. https://doi.org/10.1590/0034-7167-2015-0116
Arranz L, Guayerbas N, De la Fuente M. Impairment of several immune functions in anxious women. Journal of Psychosomatic Research. 2007;62(1):1-8. https://doi.org/10.1016/j.jpsychores.2006.07.030
Padillo-Andicoberry A, de Asís Díaz-Beato F, Sánchez-Lissen E, Romero-Pérez C. The role of hospital school education in reducing anxiety among hospitalized children. Frontiers in Education. 2025;Volume 10 - 2025. https://doi.org/10.3389/feduc.2025.1601988
Delvecchio E, Salcuni S, Lis A, Germani A, Di Riso D. Hospitalized Children: Anxiety, Coping Strategies, and Pretend Play. Front Public Health. 2019;7:250. https://doi.org/10.3389/fpubh.2019.00250
Correia AS, Cardoso A, Vale N. Oxidative Stress in Depression: The Link with the Stress Response, Neuroinflammation, Serotonin, Neurogenesis and Synaptic Plasticity. Antioxidants-Basel. 2023;12(2):470. https://doi.org/10.3390/antiox12020470
Bouayed J, Rammal H, Soulimani R. Oxidative stress and anxiety: relationship and cellular pathways. Oxid Med Cell Longev. 2009;2(2):63-7. https://doi.org/10.4161/oxim.2.2.7944

Salim S. Oxidative Stress and the Central Nervous System. The Journal of Pharmacology and Experimental Therapeutics. 2017;360(1):201-5. https://doi.org/10.1124/jpet.116.237503
Al Omran AJ, Watanabe S, Hong EC, Skinner SG, Zhang M, Zhang J, et al. Dihydromyricetin ameliorates social isolation-induced anxiety by modulating mitochondrial function, antioxidant enzymes, and BDNF. Neurobiology of Stress. 2022;21:100499. https://doi.org/10.1016/j.ynstr.2022.100499
Fedoce ADG, Ferreira F, Bota RG, Bonet-Costa V, Sun PY, Davies KJA. The role of oxidative stress in anxiety disorder: cause or consequence? Free Radic Res. 2018;52(7):737-50. https://doi.org/10.1080/10715762.2018.1475733
Samsonov A, Urlacher SS. Oxidative Stress in Children and Adolescents: Insights Into Human Biology. Am J Hum Biol. 2025;37(1):e24200. https://doi.org/10.1002/ajhb.24200
Li WHC, Chung JOK, Ho KY, Kwok BMC. Play interventions to reduce anxiety and negative emotions in hospitalized children. BMC Pediatrics. 2016;16(1):36. https://doi.org/10.1186/s12887-016-0570-5
Huhtala S, Palomaa AK, Tuomikoski AM, Pölkki T. Effectiveness of distraction-based interventions for relieving anxiety, fear, and pain in hospitalized children during venous blood sampling: a systematic review protocol. JBI Evid Synth. 2024;22(5):889-95. https://doi.org/10.11124/JBIES-22-00057
Tas FQ, van Eijk CAM, Staals LM, Legerstee JS, Dierckx B. Virtual reality in pediatrics, effects on pain and anxiety: A systematic review and meta-analysis update. Paediatr Anaesth. 2022;32(12):1292-304. https://doi.org/10.1111/pan.14546
Wong CL, Choi KC. Effects of an Immersive Virtual Reality Intervention on Pain and Anxiety Among Pediatric Patients Undergoing Venipuncture: A Randomized Clinical Trial. JAMA Network Open. 2023;6(2):e230001-e. https://doi.org/10.1001/jamanetworkopen.2023.0001
Hek K, Direk N, Newson RS, Hofman A, Hoogendijk WJG, Mulder CL, et al. Anxiety disorders and salivary cortisol levels in older adults: a population-based study. Psychoneuroendocrinology. 2013;38(2):300-5. https://doi.org/10.1016/j.psyneuen.2012.06.006
Demir E, Duzguner V, Yilmaz N, Yengil E. Changes of oxidative stress in 3D film to be prepared for echocardiography: A randomized controlled study. Medicine. 2024;103(35):e39419. https://doi.org/10.1097/MD.0000000000039419
ASA. Physical Status Classification System. American Society of Anesthesiologists 2019.
Guney E, Ceylan MF, Tektas A, Alisik M, Ergin M, Goker Z, et al. Oxidative stress in children and adolescents with anxiety disorders. J Affect Disorders. 2014;156:62-6. https://doi.org/10.1016/j.jad.2013.11.016
Ceylan MF, Guney E, Alisik M, Ergin M, Dinc GS, Goker Z, et al. Lipid peroxidation markers in children with anxiety disorders and their diagnostic implications. Redox Rep. 2014;19(2):92-6. https://doi.org/10.1179/1351000213Y.0000000082
Emhan A, Selek S, Bayazit H, Karababa IF, Kati M, Aksoy N. Evaluation of oxidative and antioxidative parameters in generalized anxiety disorder. Psychiat Res. 2015;230(3):806-10. https://doi.org/10.1016/j.psychres.2015.11.001
Aral A, Avcı B, Kesim N, Şimşek O. Oxidative Stress and Thiol-disulphide Hemostasis in Children with Anxiety Disorders. Noro Psikiyatr Ars. 2025;62(3):264-9. https://doi.org/10.29399/npa.28937
Katrencíková B, Vaváková M, Paduchová Z, Nagyová Z, Garaiova I, Muchová J, et al. Oxidative Stress Markers and Antioxidant Enzymes in Children and Adolescents with Depressive Disorder and Impact of Omega-3 Fatty Acids in Randomised Clinical Trial. Antioxidants-Basel. 2021;10(8). https://doi.org/10.3390/antiox10081256
Tas FQ, van Eijk CAM, Staals LM, Legerstee JS, Dierckx B. Virtual reality in pediatrics, effects on pain and anxiety: A systematic review and meta-analysis update. Pediatr Anesth. 2022;32(12):1292-304. https://doi.org/10.1111/pan.14546
Ahmed AE, Daak LI, Alayidh MA, Filfilan RR, Alathath RM, Rehbini AA, et al. The Role of Preoperative Virtual Reality for Anxiety Reduction in Pediatric Surgical Patients: A Systematic Review and Meta-Analysis. Cureus. 2025;17(1):e77077. https://doi.org/10.7759/cureus.77077.
McCann ME, Kain ZN. The management of preoperative anxiety in children: An update. Anesth Analg. 2001;93(1):98-105. https://doi.org/10.1097/00000539-200107000-00022
Taylan S, Kılıç KM, Özkan İ. Effects of virtual reality on pain, anxiety, and delirium in pediatric surgery: a systematic review and meta-analysis. Pediatr Surg Int. 2025;41(1):163. https://doi.org/10.1007/s00383-025-06084-w
Talarowska M, Galecki P, Maes M, Bobinska K, Kowalczyk E. Total Antioxidant Status Correlates with Cognitive Impairment in Patients with Recurrent Depressive Disorder. Neurochemical Research. 2012;37(8):1761-7. https://doi.org/10.1007/s11064-012-0788-z
Wu Y, Chen J, Ma W, Guo L, Feng H. Virtual reality in preoperative preparation of children undergoing general anesthesia: a randomized controlled study. Anaesthesiologie. 2022;71(Suppl 2):204-11. https://doi.org/10.1007/s00101-022-01177-w
Shen L, Mei C, Wang H, Xia A, Fu T, Zhu H. The effect of preoperative virtual reality on anxiety, pain and postoperative recovery in children undergoing circumcision. BMC Pediatr. 2025;25(1):940. https://doi.org/10.1186/s12887-025-06308-x

Details

Primary Language

English

Subjects

Surgery (Other), Paediatrics (Other), Clinical Sciences (Other)

Journal Section

Research Article

Authors

Emel Demir
0000-0002-4884-8989
Türkiye

Vesile Duzguner ^*
0000-0002-4101-8480
Türkiye

Ahmet Atici
0000-0002-0706-2891
Türkiye

Erhan Yengil
0000-0002-4198-4873
Türkiye

Publication Date

April 16, 2026

Submission Date

November 17, 2025

Acceptance Date

March 25, 2026

Published in Issue

Year 2026 Volume: 17 Number: 57

DOI

https://doi.org/10.17944/interdiscip.1825399

IZ

https://izlik.org/JA45EJ42LT

Cite

RIS / Bibtex

APA

Demir, E., Duzguner, V., Atici, A., & Yengil, E. (2026). Potential antioxidant effects of 3D film prepared for anxiety management in pediatric surgery clinics. Interdisciplinary Medical Journal, 17(57), 85-93. https://doi.org/10.17944/interdiscip.1825399

AMA

1.Demir E, Duzguner V, Atici A, Yengil E. Potential antioxidant effects of 3D film prepared for anxiety management in pediatric surgery clinics. Interdiscip Med J. 2026;17(57):85-93. doi:10.17944/interdiscip.1825399

Chicago

Demir, Emel, Vesile Duzguner, Ahmet Atici, and Erhan Yengil. 2026. “Potential Antioxidant Effects of 3D Film Prepared for Anxiety Management in Pediatric Surgery Clinics”. Interdisciplinary Medical Journal 17 (57): 85-93. https://doi.org/10.17944/interdiscip.1825399.

EndNote

Demir E, Duzguner V, Atici A, Yengil E (April 1, 2026) Potential antioxidant effects of 3D film prepared for anxiety management in pediatric surgery clinics. Interdisciplinary Medical Journal 17 57 85–93.

IEEE

[1]E. Demir, V. Duzguner, A. Atici, and E. Yengil, “Potential antioxidant effects of 3D film prepared for anxiety management in pediatric surgery clinics”, Interdiscip Med J, vol. 17, no. 57, pp. 85–93, Apr. 2026, doi: 10.17944/interdiscip.1825399.

ISNAD

Demir, Emel - Duzguner, Vesile - Atici, Ahmet - Yengil, Erhan. “Potential Antioxidant Effects of 3D Film Prepared for Anxiety Management in Pediatric Surgery Clinics”. Interdisciplinary Medical Journal 17/57 (April 1, 2026): 85-93. https://doi.org/10.17944/interdiscip.1825399.

JAMA

1.Demir E, Duzguner V, Atici A, Yengil E. Potential antioxidant effects of 3D film prepared for anxiety management in pediatric surgery clinics. Interdiscip Med J. 2026;17:85–93.

MLA

Demir, Emel, et al. “Potential Antioxidant Effects of 3D Film Prepared for Anxiety Management in Pediatric Surgery Clinics”. Interdisciplinary Medical Journal, vol. 17, no. 57, Apr. 2026, pp. 85-93, doi:10.17944/interdiscip.1825399.

Vancouver

1.Emel Demir, Vesile Duzguner, Ahmet Atici, Erhan Yengil. Potential antioxidant effects of 3D film prepared for anxiety management in pediatric surgery clinics. Interdiscip Med J. 2026 Apr. 1;17(57):85-93. doi:10.17944/interdiscip.1825399