“Preoperative anxiety among adults undergoing surgery - A survey"

Preoperative anxiety is described as an unpleasantstate of uneasiness or tension that is secondary to a patient being concernedabout a disease, hospitalization, anesthesia, and surgery, or the unknown. Preoperative anxiety ifunallayed is associated with intraoperative haemodynamic changes as well aspostoperative hemodynamic issues, psychological problems, delayed woundhealing, higher chances of infection etc. Though preoperative anxiety has so many negativeimplications, it is often a neglected area. Hence on assessment ofthe presence of anxiety and the level, adequate anxiolytic premedication can beprescribed and thus avoid all thecomplications associated with it. In addition, the relationship betweenanxiety and age, gender, type of surgery, education and socioeconomic statuscan be evaluated, as these may have an influence on the anxiety levels andseverity. The overall prevalenceof preoperative anxiety as reported in some studies is in range of 60–80% butsome researchers showed a wider range, which is 11–80%

There are many studies on the prevalence rates ofpreoperative anxiety among western population, few in Indian population and noneon our local population in our area and hospital. Hence I planned to study thesame.

Aimof the study: Toevaluate the Preoperative anxiety among adults undergoing surgery

Objectivesof the study:

·        Primary:Prevalence of preoperative anxiety, Level of anxiety

·        Secondary: Effect of age, gender, type of surgery, previoussurgery, education and socioeconomic status on pre-operative anxiety

Materialsand Methods:

·        Study design: Prospective, descriptive

·        Study Population:

Inclusion criteria: All Adult Patients of ASA – PS classification I and II status above 18 yearsof age undergoing any surgery requiring anaesthesia

**Exclusion criteria:**Patients with ASA – PS classification III physical status or greater, Patientsless than 18 years of age and more than 60 years of age, Unwilling patients,patients with psychiatric disorders on anti‑psychotic drugs,language or communication difficulties, renal or hepatic derangement, lowintelligence quotient.

·        Sampling Procedure: Research sample is taken from hospital patients whorequire surgery and who fulfill inclusion and exclusion criteria.

Tocalculate sample size I took Indian studies using similar assessment tests. A sample size of 412 patients is taken, determinedfrom previous studies, where the prevalence of preoperative anxiety wascomputed to be around 58%. The sample size was determined byusing a single proportion for a finite population with assumptions of 95% confidencelevel, marginal error (d) of 5% and the prevalence (P) of 58%, based on theprevious studies.  So, this proportionwas used to determine the sample size.

n= Z2 p(1-p)/d2 Where:

n= the desired sample size

Z= standard normal score (at 95% confidence level) Where: Z = 1.96

P= prevalence = (58%) = 0.58

D= degree of accuracy desired marginal error (d) of 5% = 0.05

n= 375.

Considering 10%  non-response rate. So Sample size is 412

**Benefitsof the study:**On assessing presence of anxiety and its severity,anxiety reduction methods can be employed to make it more pleasant for thepatient and for a better intra and post-operative outcome. For major surgery, preanaesthetic counselling can be given.