Patient Experiences of Pre-operative Anxiety: Comparative Analysis of General vs. Spinal Anesthesia

Background: Preoperative anxiety is a challenging concept in the preoperative care of patients. Most patients awaiting elective surgery experience anxiety and it is widely accepted as an expected response. Anxiety is described as an unpleasant state of uneasiness or tension, which may be associated with abnormal hemodynamic as a consequence of sympathetic, parasympathetic, and endocrine stimulation. It is induced by the factor (situation or object). It begins as soon as the surgical procedure is planned and increases to maximal intensity at the moment of entering the hospital.

Method: Comparative and descriptive survey approach was adopted. The population consists of patients undergoing abdominal surgery under general anesthesia vs. spinal anesthesia. Purposive sampling was used to obtain the sample of 30 patients in each group who are undergoing abdominal surgery under general anesthesia vs. spinal anesthesia. The data was collected through State Trait Anxiety Inventory questionnaire to assess pre operative anxiety of patients.

Results: Majority of patients undergoing abdominal surgery under general anesthesia (33.33%) were in the age group of less than 30 years and majority (52%) were females. 50% of them had their educational qualification as up to primary education . 50.66% had the income between Rs3001-6000. Majority (93.34%) of them had close relatives with them in the hospital. Majority (83.33%) of them had mild anxiety. Where as in patients undergoing abdominal surgery under spinal anesthesia (40%) were in the age group of less than 30 years and majority (63.34%) were females. 36.66% of them had their education up to primary education . 41% had their family income between Rs3001-6000. Majority (90%) of them had close relatives with them in the hospital. Majority (76.66%) of them had mild anxiety. Mean anxiety score of patients undergoing abdominal surgery under general anesthesia vs. spinal anesthesia was 34.03 and 34.67 respectively. There was no significant difference (t=0.48) between the anxiety level of patients undergoing abdominal surgery under general vs. spinal anesthesia. There was no significant association found between the levels of anxiety of patients with their personal variables.

Conclusion: Anxiety is the fear of anticipated threats, a negative emotion, usually unpleasant for an individual, induced by the factor (situation or object) subjectively considered as threatening. Anesthetic-surgical procedures generate anxiety in the patient who will be involved. There are several types of anxiety disorders (panic attacks, generalized anxiety disorder, mixture of anxiety-depressive disorders); however, the one that is present in the patient undergoing anesthesia for a surgical procedure is a psychological and physical discomfort that arises from the sense of immediate danger and is characterized by a widespread fear, which can range from anxiety to panic. For this reason, attention should be focused to reduce anxiety through adequate hospital care that includes a timely and efficient pre-anesthetic consultation and an appropriate psychological and/or pharmacological preparation of the patient.