Narrative review study on Reducing anxiety in preoperative Patients

Abstract:

Background:

The presence of anxiety is almost universal in the pre-operative patient. This anxiety is influenced by uncertainty about the impending procedure, by past experience of anesthesia and surgery, and by suggestions of family, friends and fellow patients. The feeling is unpleasant, and may cause patients to fail to attend for the planned surgical procedure.

Objective:

There is adequate evidence that psychological modalities for anxiety reduction re-unit in positive behavioral states which seem to combine synergistically with readily available sedative and anesthetic pharmacologic modalities, presumably yielding more safely managed anxious and fearful clinical patients. It remains to be determined if these synergistic-like effects between drug administration and enhanced behavioral modification reflect true physiologic synergisms

The aim of this study to identify the role of different intervention for reducing

preoperative anxiety.

Methods:

This study used a narrative/unsystematic review research method. Search strategy: To locate primary studies relevant to the present review, electronic publication databases research journals were searched in the period between July and September 2020. Search strings for performing the electronic searches were generated by appropriate combination of the following search terms: ‘reducing preoperative anxiety, educational intervention’, ‘satisfaction’, preoperative’, ‘teaching, ‘anxiety management. ‘Patient information’ and ‘surgery. The electronic searches were performed in the following electronic databases: Google Scholar, PubMed, Sci hub, and others.

Conclusion:

Presence of anxiety may complicate the induction of anesthesia and alter the pharmacokinetics of the agents used by inducing catecholamine release, and indeed this release of catecholamine’s can be used as a measure of anxiety. Two main methods are used at present in an attempt to reduce the patient’s anxiety, Firstly, a pre-operative visit, with reassurance and encouragement has been shown to reduce anxiety, may reduce postoperative narcotic requirements and shorten hospital stay and lead to a more prompt return to active life. Detailed explanations given to the patient do not seem to reduce anxiety more than a relatively brief explanation. Secondly, pharmacological anxiolysis with, for example, benzodiazepines or narcotics is used. It has recently been suggested that beta-adrenoceptor blockers may be used successfully in this respect Pre-operative reassurance can only hope to be successful if it is appropriate, that the potential anxieties of the patient are discussed and that new anxieties are not introduced.