Pre-operative anxiety correlation with post-operative pain level and analgesia consumption: A prospective cohort study
عارضة, علي محمد علي
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Introduction: In patients who are hospitalized for surgery, anxiety disorders are frequently observed. Anxiety affects the patient’s postoperative pain level and may significantly increase the consumption of analgesia post-operatively. Aim: The allover aim of this thesis is to identify and assess the relationship between preoperative anxiety and postoperative pain and its related factors. Also, to find the relationship between preoperative anxiety and post-operative Pethidine consumption among patients undergoing a laparoscopic cholecystectomy surgery . Method: A Prospective cohort design was used in this study. A convenience sample of total 100 patients were enrolled who were undergoing a laparoscopic cholecystectomy. Demographic characteristics of the patients were recorded. Beck’s Anxiety Inventory scale (BAIs) was administered to the patients. During the postoperative period, Pethidine was used for pain control. Visual Analog Scale (VAS) scores and Pethidine consumption of all patients were recorded. The setting of data collection was St. Joseph Hospital in Jerusalem district. The data was analyzed by SPSS (version 21). The result: Out of total sample, 35% of participants are male while 65% are female. Fifty-five percent had school education level and 45% had university level. Regarding ASA, most of participants (74%) were ASA1. Participants mean level of pain was higher in the pre-operative period (mean VAS= 1.3) comparing with their mean level of pain in the post-operative period (mean VAS= 0.5). According to BAIs, the most common feelings among the participants were psychological in nature. There is a statistical significant difference between the participant’s level of anxiety and post-operative pain level (p value < 0.001). Participants who had high level of pre-operative anxiety (BAIs ≥17) is tend to develop a higher level of post-operative pain level (VAS mean=7). Furthermore, there is a statistical significant difference between the participant’s level of anxiety and post-operative Pethidine consumption (p value < 0.001). Participants who had a high level of pre-operative anxiety (BAIs ≥17) were predisposed to consumed a higher dose of post-operative Pethidine (mean=1.1mg/kg). Gender, weight, level of education, and smoking were predictors of developing pre-operative anxiety among participants. Also, gender, smoking, and medication were statistically significant predictors for developing post-operative pain. Furthermore, gender, medical history, and medication were statistically significant predictors for Pethidine consumption post-operatively. Conclusion: Based on the analysis of the findings of the study, the following inferences were drawn. There was a significant relationship between preoperative anxiety with post-operative pain and post-operative pethidine consumption among laparoscopic cholecystectomy patients. Thus, the relationship between anxiety and pain was supported. Therefore, pre-operative anxiety reduction intervention should be promoted as an institutional policy and implemented as a routine care for all surgical patients.