Pre-operative anxiety amongst patients in a tertiary care hospital in India- a prevalence study

Abstract

Background: The prospect of undergoing surgery under anaesthesia can induce significant anxiety in patients. Excess anxiety can lead to several deleterious effects like perioperative cardiac events, increased anaesthetic requirements, higher postoperative pain scores and prolonged hospital stay. Various factors can influence the anxiety levels during surgery. The aim of the study was to estimate the prevalence of anxiety in adult patients scheduled for surgery in a suburban teaching institute in India where the majority of patients belong to lower socioeconomic strata.Methods: One hundred consecutive patients scheduled for various elective surgeries were asked 6 questions according to the Amsterdam preoperative anxiety and information scale to assess their anxiety levels just before shifting into the Operating room. Probable contributing factors noted were age, sex, socioeconomic status, type of surgery, duration of hospital stay, and history of previous surgery. Any specific factors causing anxiety like failure or complications of surgery, recovery from anaesthesia, needle pricks were also asked with leading questions.Results: The overall prevalence of anxiety was 31%. The prevalence in male patients and female patients were 21.2% and 39.5% respectively. There was a moderate correlation between the anxiety scores and need to know scores. The effects of sex, previous surgery, the length of hospital stay were not significant upon the anxiety scores.Conclusion: The overall prevalence of anxiety in the southern part of India was lower when compared to many of the reported studies; however, the prevalence was higher among the female patients.

Preoperative anxiety in Ethiopia: a systematic review and meta-analysis

“…The current finding is higher than the study from China [21], Saudi Arabia [22], India [13] and Iran [9].…”

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

“…The preoperative anxiety among surgical patients is not routinely performed as part of preoperative patient evaluation and preparation for Anesthesia and surgery (5,(74)(75)(76)(77). However, body of evidences revealed that preoperative anxiety contributed a huge impact on perioperative undesirable outcomes including increased doses of induction agents (11,22,78,79), hemodynamic instability (11,22,27,52,79), cardiac morbidity and mortality in high risk patients (26,51,64,80,81), postoperative pain and increased consumption of analgesics (18,72,74,78,(82)(83)(84)(85)(86), postoperative delirium(87), patient dissatisfaction (88)(89)(90)(91), increased hospital length of stay (29,89,92) and these in turn can incur a signi cant health care cost (1,86,89,92).…”

“…Studies conducted in India revealed that the prevalence of preoperative anxiety was varied from 47-70.3% (27)(28)(29) while the prevalence of preoperative anxiety in Pakistan was ranged from 62-97% (16,22,30).…”

Anxiety evaluation in Nepalese adult patients awaiting cardiac surgery

“…[ 2 ] Perioperative anxiety has been reported to be affected by various factors, including socio-demographic characteristics (age, gender, socioeconomic status, education level, marital status, mental diseases, past anesthesia exposure) and clinical factors (type and complexity of surgery, chronicity of disease, and nature of procedure). [ 3 – 5 ] Also, it was shown that perioperative anxiety can be ameliorated by providing preoperative education to the patients, [ 6 ] adequate provision of information before the procedure, [ 7 ] and anxiolytic medicines.…”