Effect of preoperative anxiety on postoperative pain on patients undergoing elective surgery: Prospective cohort study

Muhiddin Tadesse, Siraj Ahmed, Teshome Regassa, Timsel Girma, Seyoum Hailu, Ayub Mohammed, Salih Mohammed, Muhiddin Tadesse, Siraj Ahmed, Teshome Regassa, Timsel Girma, Seyoum Hailu, Ayub Mohammed, Salih Mohammed

Abstract

Introduction: Anxiety is a feeling of tension, apprehension, nervousness, fear, discomfort, and high autonomic activity with varying degrees of intensity resulting from anticipation of danger. Post-operative pain is associated with the emotional status, behavioural response, and high anxiety index of patients.This study aimed to assess the effect of preoperative anxiety on Postoperative Pain in Patients Undergoing Elective Surgery.

Methods: An institutional-based prospective cohort study was conducted on patients scheduled for elective surgeries from November 1, 2019, to October 30, 2020, in Dilla University Referral Hospital. Data was collected by pretested questionnaires and analysed by SPSS version 20. Categorical data were analysed by chi-square while Continuous data were analysed by student t-test and Mann Whitney U for parametric and nonparametric data respectively with a P-value of <0.05 was considered as statistically significant.

Result: As our finding revealed patients with high preoperative anxiety experienced significantly increased postoperative pain at 2 h, 4 h, 6 h, and 12 h with the P-value of 0.012, 0.01, 0.001, and 0.002 respectively and total tramadol consumption in a patient with high preoperative anxiety level is 156.5 ± 23.4 while in low anxiety 147.1 ± 39. with a p-value of 0.036.

Conclusion: High preoperative anxiety increased the immediate postoperative pain score and 24 h tramadol consumption. It would be better to decrease preoperative anxiety levels to reduce postoperative pain and 24 h analgesic consumption.

Keywords: APA, American Psychological Association; ASA, American society of anaesthesiologist; Analgesics consumption; NRS, numerical rating scale; Postoperative pain; Preoperative anxiety; S-STAI, State-Trait Anxiety Inventory Scale; SD, standard deviation.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021 The Authors.

Figures

Fig. 1
Fig. 1
Patient enrolment flow diagram.
Fig. 2
Fig. 2
Comparison of NRS scores between groups Of Patients Undergoing Elective surgery at Dilla University Referral Hospital 2020.

References

    1. VandenBos G.R. American Psychological Association; 2007. APA Dictionary of Psychology.
    1. Taenzer P., Melzack R., Jeans M.E. Influence of psychological factors on postoperative pain, mood and analgesic requirements. Pain. 1986;24(3):331–342.
    1. Halter M.J. Elsevier Health Sciences; 2017. Varcarolis' Foundations of Psychiatric-Mental Health Nursing-E-Book: A Clinical Approach.
    1. Kuzminskaitė V., Kaklauskaitė J., Petkevičiūtė J. Incidence and features of preoperative anxiety in patients undergoing elective non-cardiac surgery. Acta Med. Litu. 2019;26(1):93.
    1. Matthias A.T., Samarasekera D.N. Preoperative anxiety in surgical patients-experience of a single unit. Acta Anaesthesiol. Taiwanica. 2012;50(1):3–6.
    1. Nigussie S., Belachew T., Wolancho W. Predictors of preoperative anxiety among surgical patients in Jimma University specialized teaching hospital, South Western Ethiopia. BMC Surg. 2014;14(1):67.
    1. Srahbzu M., Yigizaw N., Fanta T., Assefa D., Tirfeneh E. Prevalence of depression and anxiety and associated factors among patients visiting orthopedic outpatient clinic at Tikur Anbessa specialized hospital, Addis Ababa, Ethiopia. J. Psychiatr. 2018;21(450):2. 2017. J Psychiatry. 21: 450.
    1. Mulugeta H., Ayana M., Sintayehu M., Dessie G., Zewdu T. Preoperative anxiety and associated factors among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia. BMC Anesthesiol. 2018;18(1):155.
    1. Balasubramaniyan N., Rayapati D.K., Puttiah R.H., Tavane P., Singh S.E., Rangan V., et al. Evaluation of anxiety induced cardiovascular response in known hypertensive patients undergoing exodontia-a prospective study. J. Clin. Diagn. Res.: J. Clin. Diagn. Res. 2016;10(8):ZC123.
    1. Pogatzki-Zahn E.M., Zahn P.K., Brennan T.J. Postoperative pain—clinical implications of basic research. Best Pract. Res. Clin. Anaesthesiol. 2007;21(1):3–13.
    1. Granot M., Ferber S.G. The roles of pain catastrophizing and anxiety in the prediction of postoperative pain intensity: a prospective study. Clin. J. Pain. 2005;21(5):439–445.
    1. Vaughn F., Wichowski H., Bosworth G. Does preoperative anxiety level predict postoperative pain? AORN J. 2007;85(3):589–604.
    1. Pogatzki-Zahn E.M.Z.P., Brennan T.J. Postoperative pain—clinical implications of basic research. Best Pract. Res. Clin. Anaesthesiol. 2007;21(1):3–13.
    1. Agha R.A.-R.A., Crossley E., Dowlut N., Iosifidis C., Mathew G. The STROCSS 2019 guideline: strengthening the reporting of cohort studies in surgery. Int. J. Surg. Open. 2019;72:156–165. for the STROCSS Group.
    1. van der Bij AK. dWS., Cikot R.J., Steegers E.A., Braspenning J.C. Validation of the Dutch short form of the state scale of the Spielberger State-Trait Anxiety Inventory: considerations for usage in screening outcomes. Publ. Health Genom. 2003;6(2):84–87.
    1. Nigussie S.B.T., Wolancho W. Predictors of preoperative anxiety among surgical patients in Jimma University specialized teaching hospital, South Western Ethiopia. BMC Surg. 2014;14(1):67.
    1. Henok Mulugeta1 M.A., Sintayehu1 Mezinew, Dessie3 Getenet, Zewdu4 Tesfu. Preoperative anxiety and associated factors,among adult surgical patients in Debre Markos and Felege Hiwot referral hospitals, Northwest Ethiopia. BMC Anesthesiol. 2018;18(155)
    1. Ali A., Altun D., Oguz B.H., Ilhan M., Demircan F., Koltka K. The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy. J. Anesth. 2014;28:222–227.
    1. Bandeira Roberto Albuquerque, et al. Correlation between preoperative anxiety and acute postoperative pain in elderly patients submitted to transvesical prostatectomy. Rev Dor São Paulo. 2017 oct-dec;18(4):291–297.

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