Preoperatory Anxiety in Patients Undergoing Cardiac Surgery

Abstract

Anxiety is a feeling of discomfort produced in face of an unknown event, as an impending cardiac surgery, that can lead to inconveniences in the intervention and subsequent recovery. Being the purpose of this research to analyze pre-surgical anxiety, a descriptive cross-sectional study among patients undergoing cardiac surgery was carried out. Data about sociodemographic variables were collected and the level of anxiety prior to surgery was assessed using the STAI-S scale. Subsequently, descriptive data analyses were performed, relationships among variables were analyzed, and a binary logistic regression model was developed in order to analyze the role of the variables involved in the development of preoperative anxiety. Sixty subjects were finally included; more than 80% had a moderate to high level of anxiety. 26.7% underwent valve surgery and 47% underwent coronary artery bypass graft (CABG) surgery, in the latter case presenting higher levels of anxiety. Statistically significant relationships were found among the level of anxiety and (a) level of studies, (b) first surgical intervention, and (c) the rating given to their previous surgical experience. We concluded that preoperative anxiety in people undergoing cardiac surgery is high and yet it is an underestimated phenomenon. The relationship between the received information and their anxiety level is inversely proportional, so that people programmed for cardiac surgery should be provided with all the information they required, through an individualized intervention.

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).…”

“…The Meta-Analysis revealed that the prevalence of preoperative anxiety was the highest in the obstetric patient(27) followed by other major surgical (11,16,21,30,35,36,38,67,69) and cardiac surgery patients (7,26) while the lowest was seen in cancer patients (25,32,(71)(72)(73). These variations can be explained by two lives in the obstetric patient, a small number of included studies, and inclusion of heterogeneous groups in studies with all surgical patients.…”

“…Mortality and morbidity associated with preoperative anxiety are more likely due to major cardiovascular problems associated with health-related behaviors such as smoking, poor diet, poor compliance with treatment, or an inactive lifestyle and direct in uence on the myocardial perfusion, autonomic nervous system regulation, platelet activation, increased hypothalamus-pituitary-adrenal axis activity and exaggerated in ammatory processes (3,4,7,8,12,13,17,26,41,44,45,50,51,57,(59)(60)(61)(62)(63)(64). However, the body of evidence on global prevalence and determinates of preoperative anxiety among surgical patients is still in demand.…”

Guidelines for enhanced recovery after cardiac surgery. Consensus document of Spanish Societies of Anesthesia (SEDAR), Cardiovascular Surgery (SECCE) and Perfusionists (AEP)

“…Según estos estudios, la incidencia se considera baja y no prolonga la estancia en la UC, por lo que no se considera necesario la administración de fármacos antieméticos como profilaxis en pacientes sin factores de riesgo [163][164][165] . 62. En pacientes sin factores de riesgo, siempre que haya un plan de rescate eficaz, se sugiere no realizar profilaxis sistemática de NVPO.…”

Neuro-Psychiatric Disorders: From Diagnosis to Care

“…Prado-Olivares and Chover-Sierra [1] reported that the level of preoperatory anxiety in patients undergoing cardiac surgery is significantly associated with level of studies, first surgical intervention, and the rating given to their previous surgical experience. The relationship between the received information and the anxiety level is inversely correlated, so these patients should be provided with all the information through an individualized intervention to reduce their anxiety and its related adverse outcomes.…”