Preoperative Anxiety Management in Surgical Patients

Preoperative anxiety is a widespread phenomenon affecting a substantial proportion of individuals awaiting surgical procedures. Heightened anxiety before surgery has been linked to increased anaesthetic requirements, amplified postoperative pain, delayed recovery and prolonged hospital stays. Risk factors include younger age, female gender, low socioeconomic status, fear of complications and insufficient information provision. Management strategies span pharmacological agents such as benzodiazepines and alpha-2 agonists, alongside non-pharmacological and psychological interventions. Preoperative psychosocial assessment and personalised counselling can identify high-risk patients and guide the use of relaxation techniques, cognitive-behavioural approaches, mindfulness and guided imagery. Integration of these methods into perioperative pathways has demonstrated improvements in patient satisfaction, reduction in analgesic consumption and optimisation of surgical outcomes. A multidisciplinary model involving anaesthetists, surgeons, nurses and psychologists is increasingly advocated to address the multifaceted nature of preoperative anxiety, ensuring both physiological and psychological needs are met.

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Preoperative Anxiety Management in Surgical Patients publication trend

The graph below shows the total number of articles in preoperative anxiety management in surgical patients across all publications each year (not limited to Nature Index journals).

Technical terms

State Anxiety: Transient subjective feelings of tension and apprehension experienced in response to an immediate threat.
Trait Anxiety: Stable personality characteristic reflecting a predisposition to respond with anxiety across situations.
Amsterdam Preoperative Anxiety and Information Scale (APAIS): Six-item questionnaire measuring patients’ anxiety about surgery and their desire for information.
Cognitive-Behavioural Therapy (CBT): Psychological intervention focusing on modifying maladaptive thoughts and behaviours to alleviate anxiety.
Mindfulness: Mental practice of non-judgmental, present-moment awareness to reduce stress and anxiety.

References

1. Evaluation of preoperative anxiety and fear of anesthesia using APAIS score. European Journal of Medical Research (2018).
2. Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis. International Journal of Surgery Open (2020).
3. Effects of psychological interventions on anxiety and pain in patients undergoing major elective abdominal surgery: a systematic review. Perioperative Medicine (2020).
4. Non-pharmacologic Approaches in Preoperative Anxiety, a Comprehensive Review. Frontiers in Public Health (2022).