Effect of preoperative anxiety on postoperative pain and quality of recovery after modified radical mastectomy

After satisfying all inclusion and exclusion criteria and written valid consent taken ,one day prior to operation patient’s anxiety will be assessed using APAIS scale .Question will be translated to local language .Surgery will be performed under general anesthesia with intraoperative pain management including injection fentanyl and dexmedetomidine .All patient’s are administered injection paracetamol 30 minute prior to extubation for postoperative pain relief .Total dose of intraoperative pain relievers will be recorded .Then postoperative pain severity will be measured using VAS  scale quality of recovery will be assessed .scale and depend on scale  score ,if VAS score >3 injection tramadol 1mg/kg administered intravenously as rescue analgesic and patient will be observed if further doses required total dose of tramadol .Then 24hours postoperatively QOR15 will be used to asses quality of recovery and depend on QOR15