Effect of preoperartive anxiety on induction haemodynamics in adult patients undergoing surgical procedures under general anaesthesia.

Document Type : Original Article

Authors

1 Department of Anaesthesiology, VMMC and Safdarjung Hospital, India.

2 Department of Anesthesia, VMMC and Safdarjung Hospital, India.

3 Department of Biological Sciences, Kusuma School of Biological Sciences, IIT Delhi, New Delhi, India.

Abstract

Background: Preoperative anxiety leads to physiological as well as mental changes. Positive correlation has been found between preoperative anxiety and haemodynamic changes during induction of anaesthesia. In our study we used State Trait Anxiety Inventory(STAI©) to evaluate such correlation. Elevation of MAP and heart rate in pre-operatively anxious patients has been primary aspect of our study. Moreover, stress response to surgery stimulates gluconeogenesis, blood glucose levels in pre-operative anxiety patients have also been quantified. 40 patients under this prospective study were interviewed to fill out STAI© questionnaire 2 hours prior to surgery. Their vitals were noted after wheeling into OT, 5 minutes after securing i/v access, 5 minutes after fentanyl administration, prior to laryngoscopy, 1 minute after intubation, every 2 minutes thereafter, starting after 1 minute after intubation, for first 10 min. Blood glucose levels were monitored during pre-operative period, 15 and 30 minutes after intubation.
Results: Of 43% male and 57% female population, females showed 1.5-fold higher STAI© scores than males, establishing positive correlation with percent changes in mean blood pressure and heart rate, during induction of anaesthesia. Overall, 40% patients exhibited high anxiety traits. Hemodynamic changes were quite significant prior to intubation, 1 minute after intubation. Furthermore, positive correlation was observed between state anxiety score and blood glucose levels after 15 and 30 minute of intubation.
Conclusions: Higher pre-operative anxiety levels are associated with more drastic changes in hemodynamic parameters and blood glucose levels. Conclusively, state anxiety score can be used as predictable entity for preoperative anxiety.

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