Pediatric patients who have unpleasant experiences in the medical field are far more stressed, and this effect is particularly felt by parents and children. Children who experience nociception or trepidation are less able to withstand and comply with medical procedures. The aim of the study was to assess how immersive 360-degree educational video in Virtual Reality (VR) affects preoperative fear and postoperative pain in a population of children undergoing tonsillectomy who are between the ages of 6 and 12. In this randomized control trial, 92 pediatric participants were randomized into two groups: an experimental group (EMG; n=46) that watched a 360° educational video through VR headset model  Oculus Meta Quest 3 , and a control group (CG; n=46). The Wong-Baker Faces Pain Rating Scale and the Children's Fear Scale were used as assessment instruments to quantify pain and fear quantitatively. A substantial difference (mean = 3.07) was revealed by baseline fear metrics in the EMG, and this difference decreased after the intervention (mean = 1.89, p < 0.001). There was a significant decrease in fear indices (mean = 1.8) in the EMG after watching the 360-degree educational film, compared to the CG (mean = 2.91), p < 0.001. Furthermore, the mean postoperative pain ratings on the EMG were recorded at 5.91, considerably lower than the mean of 7.11 (p < 0.001) on the CG. In pediatric tonsillectomy patients, the use of a 360° immersive educational film in a virtual reality environment has been shown to reduce preoperative anxiety and postoperative pain, highlighting the technology's potential as a therapeutic adjunct in pediatric surgical treatment.

Key words: video 360^o, fear, pain, preoperative, pediatrics, virtual Reality (VR)