Preoperative anxiety before elective surgery

OBJECTIVE: To ascertain the preoperative anxiety level and different factors responsible in patients admitted for an elective surgical procedure in a tertiary care public hospital. METHODS: Anxiety levels were measured in admitted patients of the Civil Hospital, Karachi, Pakistan awaiting elective surgery from October to January 2006. In the afternoon preceding surgery, patients were asked to complete 2 visual analogue scales (VAS) regarding anxiety about the proposed surgery and anesthesia (range, 0 = `not anxious at all` to 100 = `extremely anxious`). They were then asked to select different factors responsible for their anxiety from a list. RESULTS: Mean anxiety score for surgery was 57.65+/-25.1 and for anesthesia was 38.14+/-26.05. There was a statistically significant high level of pre-operative anxiety in females as compared to males (p<0.01). The most common factors contributing to anxiety were concern about family in 173 (89.6%) patients, fear of complications in 168 (87%), results of operation in 159 (82.4%), and postoperative pain in 152 (78.8%). Fifty-six percent of patients thought that their anxiety would be lessened by a detailed explanation regarding the operation and anesthesia. CONCLUSION: Our patients experience very high levels of preoperative anxiety. This can be easily measured in the preoperative period and allows detection of patients with high anxiety, encouraging appropriate steps to ameliorate this. Establishment of preoperative counseling clinics and properly informed consent taken before surgery will help in reducing preoperative anxiety.