{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T06:34:55Z","timestamp":1776926095503,"version":"3.51.2"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Perioperative anxiety is a widespread psychological issue among patients undergoing surgery and often has a significant impact on patient outcomes. Due to physiological and psychological characteristics such as hormonal fluctuations and higher emotional sensitivity, female patients generally have a higher incidence of perioperative anxiety compared to male patients. This investigation aims to examine the repetitive transcranial magnetic stimulation (rTMS) effects on perioperative anxiety in female patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This single-center, randomized, regulated investigation will be performed at the Affiliated Hospital of Jiaxing University. The investigation plans to enroll 252 female individuals scheduled for elective surgery under general anesthesia, who will be classified in a random manner to active rTMS or sham rTMS. The primary outcome is the change in anxiety score from baseline to 3\u202fdays post-operation. Secondary outcome measures include anxiety scores, occurrence of postoperative delirium (POD), pain scores, frailty scores, and sleep quality scores. Intention-to-treat and per-protocol populations were employed to conduct analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This research aims to estimate the influence of rTMS on perioperative anxiety in female patients. It is expected to offer a successful non-pharmacological treatment approach for clinical practice, alleviate anxiety symptoms in female patients during the perioperative period, and enhance the safety of surgical procedure and the quality of post-operative recovery for patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.chictr.org.cn\/index.html<\/jats:ext-link>\n                      , identifier ChiCTR2500097991.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1832192","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:35:40Z","timestamp":1776922540000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of repetitive transcranial magnetic stimulation on perioperative anxiety in female patients: study protocol for a single-center, randomized controlled study"],"prefix":"10.3389","volume":"13","author":[{"given":"Wenhui","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Anesthesia Medicine, Zhejiang Chinese Medical University","place":["Zhejiang, Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sitong","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Medicine, Zhejiang Chinese Medical University","place":["Zhejiang, Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunlai","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Medicine, Zhejiang Chinese Medical University","place":["Zhejiang, Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuxuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Anesthesia Medicine, Zhejiang Chinese Medical University","place":["Zhejiang, Hangzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huadong","family":"Ni","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University","place":["Jiaxing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Yao","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Pain Research Center, The Affiliated Hospital of Jiaxing University","place":["Jiaxing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1097\/ACO.0000000000001186","article-title":"Preoperative anxiety","volume":"35","author":"Friedrich","year":"2022","journal-title":"Curr Opin 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