Summary

SummaryI'here is an increase of interest in the psychological preparation of patients for surgery. Most studies have used postoperative measures: analgesic requirements, length of hospital stay and patient satisfaction. Pre-operative interventions dcsigncd to increase patient understanding, reduce anxiety and aid recovery have included films, modelling, brochures. counselling. group discussions and hypnosis.' In a meta-analysis of 34 controlled studics thc iisc o f psychological interventions was cxamined on preopcrativc surgical patients and paticnts who had suffered myocardial infarction.' A reduction in the experimental group's stay i n hospital by approximately 2 days was rccordcd. which suggcstcd that physical, psychological and cconomic benefits may accrue from such interventions.Tlic examination of pre-operative influences upon postopcr-ativc variablcs is uscful, but fcw studies have invcstigated the influcncc of pre-operative psychological variables upon intra-opcrativc factors such as anaesthetic requirenictits. A rcduction in either anxiety or medication might also prove clinically useful, as pic-opcrative anxiety is gcncrally an indication of need for increased analgesia and anacsthesia, and often a signal for a difficult induction. Daycase surgery i s known to provoke pre-operative anxicty, and although thc operations may be minor, the patient's level of. anxiety often is not. Prernedication is not given routinely to day cases.The present research project sought to answcr thc following questions: are hypnosis or a discussion 0 1 similar length equally effective ways to reduce pre-operative anxiety: does reduced anxiety result in decreased intraoperative anaesthetic requirements; and clo pre-opcrativc psychological factors predict highcr anaesthetic rcquircments? MethodsFifty-thrcc women. average age 24.6 years. who WT'C to have elective gynaecological surgery in the L h y Surgery Unit at Addenbrooke's Hospital. Cambridge. were intervicwcd individually by a consultant or scnior registrar anaesthetist and then escorted by ;I iiursc t o it coniinunal waiting area. Each patient was called in turn to be intcrviewed by a psychologist. The intcrviews lasted an avcragc of 8 minutes, aftcr which tlic patient was brought into the opcrating theatre. This eliminated any opportunity for discussion between patients. The elements of the intervicw are described bclow.E.vplimitii~n of' file .sftrc/J' mid i i~i t t e n consoit. The patients

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