Link Between Preoperative Inflammatory Biomarkers, Anxiety Levels, and Emergence Agitation in Pediatric Patients
By
Nezahat Merve Ata Soylu
Zehra Hatipoglu
Ersel Gulec
Mediha Turktan
Nurefsan Sadıkoglu
Yusuf Kemal Arslan
Dilek Ozcengiz
June 18, 2026
Clinical Scorecard: Link Between Preoperative Inflammatory Biomarkers, Anxiety Levels, and Emergence Agitation in Pediatric Patients
At a Glance
Category Detail
Condition Preoperative Anxiety and Emergence Agitation Key Mechanisms Neuroinflammatory mediators, HPA axis activation, sympathetic nervous system response, cytokine release. Target Population Pediatric patients aged 5-12 years scheduled for elective or emergency surgery. Care Setting Preoperative surgical units.
Key Highlights
Preoperative anxiety affects up to 65% of pediatric patients. Emergence agitation occurs in 0.25%–90.5% of children post-anesthesia. Inflammatory markers such as NLR and SII may indicate neuroinflammatory risk. The study included 350 patients with ASA physical status I to II. Anxiety levels were assessed using the modified Yale Preoperative Anxiety Scale (m-YPAS). Guideline-Based Recommendations
Diagnosis
Assess preoperative anxiety using m-YPAS with a threshold score of ≥ 40. Management
Monitor inflammatory markers from hemogram parameters preoperatively. Monitoring & Follow-up
Evaluate emergence agitation using the PAED score during the first 30 minutes post-anesthesia. Risks
Preoperative anxiety is a risk factor for emergence agitation. Patient & Prescribing Data
Children aged 5-12 years undergoing surgery.
Consider the role of inflammatory markers in managing preoperative anxiety and emergence agitation.
Clinical Best Practices
Implement routine assessment of anxiety levels in pediatric patients preoperatively. Utilize hemogram-derived inflammatory markers to evaluate neuroinflammatory risk. Related Resources & Content
