[The relationship between different medical environment familiarity and preoperative anxiety, anesthesia induction, and recovery in children undergoing adenotonsillectomy].

<b>Objective:</b> To investigate the influence of medical environment familiarity on preoperative anxiety, anesthesia induction compliance, and emergence agitation (EA) in children undergoing adenotonsillectomy in a day surgery setting. <b>Methods:</b> A retrospective analysis was conducted on children undergoing elective adenotonsillectomy in a day surgery setting under general anesthesia at the Second Affiliated Hospital of Wenzhou Medical University between January 2018 and December 2019, October 2020 and November 2022, and March and December 2023. The children were divided into three groups according to their familiarity with the medical environment: the control group (Group C), which included children from January 2018 to December 2019; the familiar group (Group F), which comprised children from October 2020 to November 2022; and the fairly familiar group (Group FF), which encompassed children from March to December 2023. The modified Yale preoperative anxiety scale (m-YPAS) score, parental separation anxiety scale (PSAS) score, open vein compatibility score, and induction compliance checklist (ICC) score were compared among the three groups. Multivariate logistic regression analysis was performed to identify factors associated with preoperative anxiety and the occurrence of EA. <b>Results:</b> A total of 754 children aged (4.8±1.3)years were included, with 485 boys and 269 girls. There were 289, 206, and 259 children in group C, F, and FF, respectively. The incidence of EA was lower in the group F [33.0% (68/206)] and group FF [17.0% (44/259)] compared to the group C [65.4% (189/289)] (all <i>P</i><0.001). Multivariate logistic regression analysis showed that compared to the control group, familiar and fairly familiar with the medical environment were protective factors associated with lower m-YPAS score (<i>OR</i>=0.227, 95%<i>CI</i>: 0.155-0.333; <i>OR</i>=0.292, 95%<i>CI</i>: 0.205-0.416), lower PSAS score (<i>OR</i>=0.239, 95%<i>CI</i>: 0.158-0.364; <i>OR</i>=0.137, 95%<i>CI</i>: 0.087-0.213), lower ICC score (<i>OR</i>=0.118, 95%<i>CI</i>: 0.071-0.194; <i>OR</i>=0.224, 95%<i>CI</i>: 0.166-0.359), and a lower risk of EA (<i>OR</i>=0.511, 95%<i>CI</i>: 0.298-0.877; <i>OR</i>=0.161, 95%<i>CI</i>: 0.084-0.307). Additionally, these factors were associated with higher open vein compatibility score (<i>OR</i>=3.858, 95%<i>CI</i>: 2.624-5.672; <i>OR</i>=6.807, 95%<i>CI</i>: 4.569-10.141) (all <i>P</i><0.05). <b>Conclusions:</b> Familiarity with the medical environment significantly influenced the psychological and behavioral outcomes of children undergoing surgery. Greater familiarity was associated with reduced preoperative parental separation anxiety, improved cooperation during anesthesia induction, and a lower incidence of EA.