Comparison of the Effects of Preoperative Anesthesia Evaluation on Preoperative Anxiety Using Anxiety Scales and Evaluation of Patient Satisfaction; Prospective Study

Anxiety is one of the diseases that has recently attracted worldwide attention and seriously affects daily life. Preoperative anxiety is a significant problem for patients because it causes physical problems as well as emotional and psychiatric disorders. It negatively affects surgery, anesthesia and postoperative recovery and is seen in 60-80% of patients scheduled for surgery. Most patients experience varying degrees of anxiety and fear before surgery. This anxiety and fear may depend on the type of anesthesia, as well as the patient's previous experiences, personality traits, concerns about the surgical procedure and postoperative pain. Preoperative anxiety causes difficulties in anesthesia induction, autonomic fluctuations and increased anesthetic requirements, and has been associated with increased pain, nausea and vomiting, prolonged recovery and prolonged hospitalization in the postoperative period. Anxious patients encounter complications in the perioperative period at a higher incidence. Anxiety assessment is important because anxious patients' responses to anesthesia and analgesia are different than those of non-anxious patients. For this purpose, anxiety can be assessed in many ways, directly by measuring plasma cortisol and urinary catecholamines, and indirectly by measuring pulse and blood pressure.

Preoperative anxiety begins when the surgical procedure is planned and reaches its maximum intensity at hospital admission. Correct management of fear and anxiety is achieved by a better preoperative assessment and information provided by anesthesiologists. Therefore, anxious patients should be routinely identified during preoperative assessment.

In practice, there are different anxiety scales that can be used to define patient anxiety within a limited time. Many documents have been reported on the assessment of preoperative anxiety. One of these is the State-Trait Anxiety Inventory (STAI) scale, which is the most widely used test for assessing anxiety at a specific time. In addition, the Amsterdam Preoperative Anxiety and Information Scale (APAIS), which is simpler and less time-consuming to apply, was developed to measure anxiety and desire for information related to anesthesia and surgery, and its usability and correlation with STAI were investigated. The Visual Analog Scale (VAS) (range 0-100 mm) is an alternative scale used to assess anxiety, consisting of a 100 mm line; zero on the left indicates no anxiety, while 100 mm on the right indicates extreme anxiety.

Previous studies have identified that patients feel anxious before elective surgery, but studies investigating the effect of preassessment clinics (PACs) on anxiety levels have been limited to the use of patient information literature or multimedia rather than the preoperative anesthesia consultation process. Since PACs have the potential to provide patients with a better understanding of their anesthesia and surgery, they have the potential to reduce anxiety.

The aim of this study was to measure the degree of preoperative anxiety in patients presenting to our anesthesia outpatient clinic before and after the preoperative anesthesia assessment using the STAIT, APAIS and VAS anxiety scales, and to investigate the effect of the preoperative anesthesia interview on anxiety and to evaluate patient satisfaction.