ASSA13-14-26 Preoperative Anxiety is Associated with Higher Blood Pressure in Patients Waiting For Surgery

Abstract

ObjectiveThe relationship of preoperative anxiety and blood pressure (BP) has not been fully investigated. This study assesses the impact of preoperative anxiety on BP. Methods A total of 660 in-patients waiting for elective surgery were enrolled. Repeated BPs were measured after admission (basic BP), in every morning, after anesthesiologist visit (BPv) and 30 min before entering operation room (BPe). The BPs taken in the 3 days before and after operation were recorded as BP-3, BP-2 and BP-1 as well as BP1, BP2 and BP3 respectively. The difference between the BPe and basic BP was calculated as the BP increase amplitude (ΔBP). The anxiety scale was evaluated ( > 50 points anxiety) after anesthesiologist visit for all patients. Results The SBP and DBP continuously increased before operation and to the peak before entering operation room. The SBPe (136 ± 15 vs 118 ± 14mmHg, P < 0.05) and the DBPe (79 ± 9 vs 72 ± 9mmHg, P < 0.05) were significantly higher than their basic values respectively. After operation both SBP and DBP decreased. The prevalence of preoperative anxiety was 37.1%. The anxiety group has higher basic SBP, pre-operative SBP and ΔSBP, but more rapid SBP and ΔSBP decline than non-anxiety group. The profile of DBP change was similar to, but weaker than that of SBP in the observation duration. Multifactor analysis demonstrated that anxiety scale was positively associated with ΔSBP. Conclusions The patients with anxiety have obvious BP fluctuation and anxiety scale is positively associated with the SBP increase during the preoperative duration.

Global Prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and Meta-analysis

“…Literature mentioned that preoperative anxiety depends on age, gender, marital status, educational level, fear of postponed of surgery, types of surgery, fear of anesthesia, fear of surgery, fear of awakening in the middle of surgery, nancial loss, fear postoperative pain, fear of death and fear of unknown origin (2,4,6,12,25,33,35,36,(38)(39)(40)(41)(42)(43)(44)(45)(46)(47). However, the leading cause of preoperative anxiety frequently mentioned in the literature was the outcomes of surgery which accounted for (29.3%) followed by fear of postoperative course (19.5%) and complications during/after the procedure (11.4%) (48).…”

Virtual reality to reduce periprocedural anxiety during invasive coronary angiography: rationale and design of the VR InCard trial

“… 3 Anxiety can lead to physiological and psychological complications, compromising patient comfort and overall procedural outcomes. 4 Therefore, identifying effective strategies to reduce anxiety in patients undergoing an ICA is important.…”

Preprocedural Anxiety in the Transradial Cardiac Catheterization Era

“…22 In addition, high levels of anxiety have been reported to cause elevated blood cortisol levels, and increased blood pressure and heart rate. 23 Anxiety also creates an increase in sympathetic activity, which then amplifies the risk of dysrhythmias and ischemia occurring during the cardiac catheterization procedure, 24 which in turn may have an effect on the success of the procedure. Success of the procedure remains a main reason for high anxiety because patients fear the need for further invasive procedures such as bypass surgery.…”

“…High levels of anxiety before transfemoral cardiac catheterization have been associated with uncertainty relating to possibility of a diagnosis of CAD, anticipated procedural failure, procedural discomfort, and complications 22 . In addition, high levels of anxiety have been reported to cause elevated blood cortisol levels, and increased blood pressure and heart rate 23 . Anxiety also creates an increase in sympathetic activity, which then amplifies the risk of dysrhythmias and ischemia occurring during the cardiac catheterization procedure, 24 which in turn may have an effect on the success of the procedure.…”