AI-Generated Maternal Voice Storytelling During Pediatric Adenotonsillectomy

Pediatric adenotonsillectomy is frequently associated with perioperative anxiety,autonomic stress responses, and emergence delirium despite standardized anestheticmanagement. Non‐pharmacological auditory interventions, including music and maternalvoice exposure, have been investigated as potential strategies to improve perioperativeoutcomes. However, the effects of personalized artificial intelligence (AI)‐generatedmaternal voice storytelling have not been evaluated in pediatric surgical patients.This prospective, single‐center, three‐arm randomized controlled trial will investigatethe effects of AI‐generated maternal voice storytelling on perioperative stress response,emergence delirium, anesthetic requirements, and perioperative physiological parametersin children undergoing elective adenotonsillectomy under general anesthesia. Participantswill be randomly assigned to one of three groups: (1) AI‐generated maternal voicestorytelling, (2) relaxing instrumental music, or (3) standard care without auditoryintervention.The assigned auditory intervention will be initiated after premedication and continuedthroughout the perioperative period using headphones. Standardized anesthesia protocolswill be applied to all participants. Emergence delirium will be assessed using thePediatric Anesthesia Emergence Delirium (PAED) scale. Secondary outcomes will includeinduction compliance, perioperative hemodynamic variables, sevoflurane consumption,postoperative pain scores, and recovery characteristics. The study aims to determinewhether personalized AI‐generated maternal voice storytelling influences perioperativeoutcomes compared with relaxing music and standard perioperative care.