Prasad Kulkarni1, Kartik Nagashiva Badaru2, Srirang Joshi3, Srinivasa B4, Hoysala H. N5
INTRODUCTION: Anxiety is a "psychophysiological phenomenon experienced as a foreboding dread or threat to a human organism whether the threat is generated by internal, real or imagined dangers.1 Anxiety has been described as a subjective feeling of distress and anguish that has affective, motivational, behavioral, and physiologicalcomponents.2 A key feature of anxiety is its subjective nature.
The anticipation of undergoing surgery or anesthesia can cause psychological stress to patients which are manifested as anxiety.3 The cause of patients' preoperative anxiety is multifactorial. It can be divided into three distinct dimensions of anxiety, 1) fear of the unknown. 2) Fear of the waiting period before surgery/anesthesia. 3) Fear of unconsciousness and other anxieties like fear of feeling ill, fear of postoperative nausea or vomiting fear of perioperative pain, fear of the discomfort of postoperative awakening fear of intraoperative awareness, fear for one’s life fear of not regaining consciousness, a fear of dying or remaining in coma, fear of anesthesia-induced physical or mental harm.
Young patients, female patients, patients with less education and patient’s with no previous anaesthetic experience or a previous negative anaesthetic experience will have higher anxiety scores-4
Operations associated with high preoperative anxiety include thoracic and otorhinolaryngological surgery.4
It has been shown that psychologically prepared patients who are less anxious before surgeries have improved postoperative clinical recovery as assessed by outcomes such as pain and analgesic use, postsurgical complications, and hospital
The measures to allay pre-operative anxiety include Non pharmacologic interventions such as:
1. Anaesthetist's visit is more effective than a sedative pre medicant in relieving preoperative anxiety.3
2. Hypnosis may also have a positive effect in reducing pain and anxiety.3
3. Provision of information, distraction, attention focusing.4
4. Relaxation procedures.4