Anesthesia & Intensive Care Medicine - Juniper Publishers
Introduction
The preoperative anxiety is a temporary emotional
state caused by anxiety, nervousness, fear and high autonomic nerve
system activation arising from these feelings that the patients have
prior to the operation [1]. It is known that endocrine systems also play
a role in preoperative anxiety symptoms [2]. Preoperative anxiety, a
common phenomenon in preoperative patient evaluation, is a process that
starts from the date of planning a given operation and progressively
intensifies up to the moment of the operation itself. The incidence of
preoperative anxiety has been reported to range from 11% to 80% among
adult patients [3]. In children, preoperative anxiety has been shown to
be a risk factor for postoperative state-anxiety [4].
Preoperative Anxiety Overview
There are many risk factors for preoperative anxiety
in patients undergoing elective surgery. History of cancer, psychiatric
disorders, future self-perception, depressive symptoms, traitanxiety,
pain level, history of smoking, extent of surgery to be performed,
female gender, years of formal education and physical status constituted
independent risk factors for high preoperative state anxiety [5]. Every patient is known different levels of anxiety
due to various aspects such as the previous experiences, personality
characteristics, anesthetics and surgery types to be applied and the
pain expectation after the surgery [6]. In addition to the negative
effects of preoperative anxiety on vital findings, it was also reported
that it extends the recovery period and the staying time in hospital and
that it has negative effects on postoperative pain and on nausea and
vomiting [5,7].
Anxiety can produce aggressive reactions that result
in an increase in the distress experienced by the patient, and make the
management and control of postoperative pain more difficult [8,9]. In
addition, anxiety may determine more frequent demands for analgesics in
patient-controlled analgesia [10], as well as increased intraoperative
anesthetic requirements [3]. It may also
produce a lower level of satisfaction with the treatment. Therefore,
individuals in charge of preoperative management would probably be more
effective in handling a patient’s preoperative anxiety if they had more
knowledge about potential predictors of preoperative anxiety. Anxiety
may interfere substantially with a patient’s comfort, quality of life,
ability to make appropriate treatment decisions, and treatment
compliance, thus affecting survival.
Conclusion
It is highly important in surgical practice to
observe patients carefully and appropriate preoperative anxiety
management to avoid the bothersome intraoperative and postoperative
results of preoperative anxiety. The measurements of preoperative
anxiety should be made as routine procedures. The anxiety levels that
will be determined in these routine procedures could facilitate the
determination of the premedication doses to be given and prevent to
postoperative complications.
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