Effects of Preoperative Anxiety on Postoperative Outcomes and Sleep Quality in Patients Undergoing Laparoscopic Gynecological Surgery

Abstract

Objective: Preoperative anxiety is a psychological state that commonly occurs before surgery and may have a negative impact on postoperative outcomes. This study aimed to investigate the effects of preoperative anxiety on postoperative sleep quality and recovery outcomes among patients undergoing laparoscopic gynecological surgery. Methods: The study was conducted as a prospective cohort study. A total of 330 patients were enrolled and underwent laparoscopic gynecological surgery. After assessing the patient’s preoperative anxiety score on the APAIS scale, 100 patients were classified into the preoperative anxiety (PA) group (preoperative anxiety score > 10) and 230 patients into the non-preoperative-anxiety (NPA) group (preoperative anxiety score ≤ 10). The Athens Insomnia Scale (AIS) was assessed on the night before surgery (Sleep Pre 1), the first night after surgery (Sleep POD 1), the second night after surgery (Sleep POD2), and the third night after surgery (Sleep POD 3). Postoperative pain was evaluated by the Visual Analog Scale (VAS), and the postoperative recovery outcomes and adverse effects were also recorded. Result: The AIS score in the PA group was higher than that of the NPA group at Sleep-pre 1, Sleep POD 1, Sleep POD 2, and Sleep POD 3 (p < 0.05). The VAS score was higher in the PA group than in the NPA group within 48 h postoperatively(p < 0.05). In the PA group, the total dosage of sufentanil was significantly higher, and more rescue analgesics were required. Patients with preoperative anxiety showed a higher incidence of nausea, vomiting, and dizziness than those without preoperative anxiety. However, there was no significant difference in the satisfaction rate between the two groups. Conclusion: The perioperative sleep quality of patients with preoperative anxiety is worse than that of patients without preoperative anxiety. Moreover, high preoperative anxiety is related to more severe postoperative pain and an increased requirement for analgesia.

Evaluation of the Relationship Between Preoperative Patient Anxiety Level and Health Literacy

“…On the contrary, there are also studies indicating that there is no relationship between educational status and preoperative anxiety. [22,23] In the current study, there was no statistically significant difference between educational status and anxiety. In most of the studies evaluating the relationship between health literacy and educational status, it is stated that as the level of education of individuals increases, the level of health literacy also increases.…”

“…In some studies, it was found that people with higher level of education had higher levels of preoperative anxiety. [2,12,14,15,21,22] This result was explained by the fact that as the level of education of patients increased, their awareness of the risks of anesthesia and surgery increased, and that these individuals were more capable of expressing their anxiety. [21] However, individuals with a high level of education are expected to research more and be able to cope with stress more comfortably since they have higher knowledge.…”

Perioperative Sleep Disturbance in Surgical Patients: A Concept Analysis

“…Numerous studies have demonstrated that preoperative anxiety and depression adversely affect sleep quality both before and after surgery. Higher levels of psychological distress correlate with poorer sleep quality during the perioperative period, leading to a higher incidence of PSD (Du et al, 2023; Gu et al, 2023; Huang et al, 2021; Mansano-Schlosser et al, 2017; S. J.Wang et al, 2022; Z.Wang et al, 2023; Wright et al, 2010).…”