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Background  Hospital anxiety caused by strabismus surgery has an unpleasant and disturbing feeling for both children and their parents. This study aimed to determine the effect of viewing a self-produced audio-visual animation introduction on preoperative anxiety and emergence agitation of pediatric patients undergoing strabismus surgery.    Methods  In this prospective randomized study, 1 hundred children scheduled for strabismus surgery with aged 3 ~ 6 years. The children were randomly divided into 2 groups ( n  = 50 for each), Group A: using a self-produced audio-visual animation introduction; Group C: controlled group without audio-visual animation introduction. Children’s preoperative anxiety was determined by the modified Yale Preoperative Anxiety Scale (mYPAS) at different time points: the night before surgery(T1), at pre-anesthetic holding room(T2), and just before anesthesia induction(T3). The Spielberger State-Trait Anxiety Inventory (STAI) was used to record the anxiety of parents at T1,T2 and T3. The incidence and the degree of emergence agitation were recorded.    Results  The mYPAS scores at T2 and T3 were higher than T1( p  < 0.05) in both groups. The average score of mYPAS in Group A was significantly lower than in Group C at T2 and T3( p  < 0.05). The STAI scores in Group A at T2 and T3 were significantly lower than in Group C( p  < 0.05). The incidence of agitation in Group A was lower than that in Group C( p  < 0.05).    Conclusions  Based on the findings, viewing a self-produced audio-visual animation can effectively alleviate the preoperative anxiety for both children and their parents in pediatric strabismus surgery, and it was effective for reducing emergence agitation as well.    Trial registration  The trial was prospectively registered before patient enrollment at Chinese Clinical Trial Registry (Clinical Trial Number:  ChiCTR1900025116 , Date: 08/12/2019).    Supplementary Information  The online version contains supplementary material available at 10.1186/s12886-021-01922-6.

Self-produced audio-visual animation introduction alleviates preoperative anxiety in pediatric strabismus surgery: a randomized controlled study