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Research Article| Volume 33, ISSUE 5, P691-696, September 2019

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Assessment and Management of Preoperative Anxiety

      Summary

      Background

      Preoperative anxiety has the potential to alter the dynamics of an elective procedure and has been shown to detrimentally affect patients both cognitively and physiologically. If mismanaged, it can lead to essential procedures being postponed or canceled, delay postoperative recovery, and increase patients' requirements for medical intervention postoperatively. These outcomes have harmful implications both clinically and economically. Our primary objective was to evaluate the levels of anxiety patients experience immediately before elective otorhinolaryngologic procedures. Our secondary outcome was to assess the subjects' views on potential management strategies to tackle their anxiety.

      Methods

      This is an observational cross-sectional project evaluating 53 patients who were selected consecutively from a list of elective otorhinolaryngologic procedures. All procedures were to be completed under general anesthetic, and all patients had received the same preoperative assessment preparation. 29 male and 24 female patients were included, aged between 19 and 76 years (mean 45). The Spielberger State-Trait Anxiety Inventory was used to assess preoperative anxiety directly before the otorhinolaryngologic procedure. The Service Improvement questionnaire was used to assess whether patients would favor the introduction of anxiety-reduction measures.

      Results

      There was neither a significant increase in patient anxiety levels preoperatively (P = 0.37) nor a significant increase in anxiety levels preoperatively when results were stratified according to patient gender and age (P = 0.45 and P = 0.27). 54% of the patients felt that their anxiety would have been reduced if they had read a procedural information leaflet, and 22% felt it would have been reduced if they had received preoperative behavioral training. 17% of the patients wanted more information from the surgical team. However, 12% of the patients would have liked less information from the surgical team preoperatively.

      Conclusions

      Patients did not have a significant increase in their anxiety levels preoperatively. On the basis of our findings, we will work to improve the information we provide to patients preoperatively and to identify patient subgroups that require additional preoperative support.

      Key Words

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      References

        • Hutson M.M.
        • Blaha J.D.
        Patients' recall of preoperative instruction for informed consent for an operation.
        J Bone Joint Surg Am. 1991; 73: 160-162
        • Frasure-Smith N.
        • Lespérance F.
        Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease.
        Arch Gen Psychiatry. 2008; 65: 62-71
        • Székely A.
        • Balog P.
        • Benkö E.
        • et al.
        Anxiety predicts mortality and morbidity after coronary artery and valve surgery—a 4-year follow-up study.
        Psychosom Med. 2007; 69: 625-631
        • Maranets I.
        • Kain Z.N.
        Preoperative anxiety and intraoperative anesthetic requirements.
        Anesth Analg. 1999; 89: 1346-1351
        • Ip H.Y.
        • Abrishami A.
        • Peng P.W.
        • et al.
        Predictors of postoperative pain and analgesic consumption: a qualitative systematic review.
        Anesthesiology. 2009; 111: 657-677
        • Goldmann I.
        • Ogg T.W.
        • Levey A.B.
        Hypnosis and daycase anaesthesia: a study to reduce pre-operative anxiety and intra-operative anaesthetic requirements.
        Anaesthesia. 1988; 43: 466-469
        • Kain Z.N.
        • Sevarino F.
        • Alexander G.M.
        Preoperative anxiety and postoperative pain in women undergoing hysterectomy. A repeated-measures design.
        J Psychosom Res. 2000; 49: 417-422
        • Hobson J.A.
        • Slade P.
        • Wrench I.J.
        Preoperative anxiety and postoperative satisfaction in women undergoing elective caesarean section.
        Int J Obstet Anesth. 2006; 15: 18-23
        • Thomas T.
        • Robinson C.
        • Champion D.
        • et al.
        Prediction and assessment of the severity of post-operative pain and of satisfaction with management.
        Pain. 1998; 75: 177-185
        • Caumo W.
        • Schmidt A.P.
        • Schneider C.N.
        Risk factors for preoperative anxiety in adults.
        Acta Anaesthesiol Scand. 2001; 45: 298-307
        • Kiyohara L.Y.
        • Kayano L.K.
        • Oliveira L.M.
        Surgery information reduces anxiety in the pre-operative period.
        Rev Hosp Clin Fac Med Sao Paulo. 2004; 59: 51-56
        • Jones M.P.
        • Ebert C.C.
        • Sloan T.
        • et al.
        Patient anxiety and elective gastrointestinal endoscopy.
        J Clin Gastroenterol. 2004; 38: 35-40
        • Spielberger C.D.
        • Gorsuch A.
        • Lushane R.
        • et al.
        Manual for the State-Trait Anxiety Inventory.
        Consulting Psychologists Press, Palo Alto, CA1970
        • Spielberger C.D.
        Manual for the State-Trait Anxiety Inventory STAI.
        Consulting Psychologists Press, Inc, Redwood City, CA1983
        • Jlala H.A.
        • French J.L.
        • Foxall G.L.
        • et al.
        Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia.
        Br J Anaesth. 2010; 104: 369-374
        • Gillies M.A.
        • Baldwin F.J.
        Do patient information booklets increase perioperative anxiety?.
        Eur J Anaesthesiol. 2001; 18: 620-622
        • Oldman M.
        • Moore D.
        • Collins S.
        Drug patient information leaflets in anaesthesia: effect on anxiety and patient satisfaction.
        Br J Anaesth. 2004; 92: 854-858
        • Galaal K.A.
        • Deane K.
        • Sangal S.
        • et al.
        Interventions for reducing anxiety in women undergoing colposcopy.
        Syst Rev. 2007; (CD006013)
        • Goldberger J.J.
        • Kruse J.
        • Kadish A.H.
        • et al.
        Effect of informed consent format on patient anxiety, knowledge, and satisfaction.
        Am Heart J. 2011; 162: 780-785
        • Bringman H.
        • Giesecke K.
        • Thörne A.
        • et al.
        Relaxing music as pre-medication before surgery: a randomised controlled trial.
        Acta Anaesthesiol Scand. 2002; 39: 352-359
        • Yung P.M.
        • Chui-Kam S.
        • French P.
        • et al.
        A controlled trial of music and pre-operative anxiety in Chinese men undergoing transurethral resection of the prostate.
        J Adv Nurs. 2002; 39: 352-359