Preoperative anxiety is associated with adverse consequences such as emergence delirium, and postoperative behavioral changes. According to previous studies, providing information of anesthetic procedures helps to lessen preoperative anxiety. However, verbal explanation alone provides the limited effect, and the tour program of the operating room prior to surgery may not be possible for a number of hospitals due to organizational and financial reasons. Therefore, the virtual reality (VR) tour of the operating room may be an innovative and novel method to give children information about the preoperative process and to alleviate the preoperative anxiety. In this study, we intend to evaluate the effects of the operating room virtual tour on preoperative anxiety as well as emergence delirium and postoperative behavioral changes, in pediatric patients.

Inclusion Criteria:

• Elective surgery
• American Society of Anesthesiologist (ASA) physical class I, II
• Informed consent; Children aged between 4 and 6 years old are allowed to have verbal consent and their parents provide informed written consent. Children over the age of 7 are required to obtain a written consent with parental permission.

Exclusion Criteria:

• ASA class ≥ III
• Major surgery needing postoperative intensive care unit (ICU) admission.
• Chronic disease or history of preterm birth
• Developmental delay
• Hearing or vision impairment
• Affective disorder
• History of epilepsy or seizure
• Previous experience of general anesthesia