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Preoperative anxiety about spinal surgery under general anesthesia
Authors:Jun-Seok Lee  Yong-Moon Park  Kee-Yong Ha  Sung-Wook Cho  Geun-Hyeong Bak  Ki-Won Kim
Affiliation:1.Department of Orthopaedic Surgery, Yeouido St. Mary’s Hospital, College of Medicine,The Catholic University of Korea,Seoul,Korea;2.Department of Preventive Medicine, College of Medicine,The Catholic University of Korea,Seoul,Korea;3.Department of Orthopaedic Surgery, Seoul St. Mary’s Hospital, College of Medicine,The Catholic University of Korea,Seoul,Korea
Abstract:

Purpose

No study has investigated preoperative anxiety about spinal surgery under general anesthesia. The purposes of this study were (1) to determine how many patients have preoperative anxiety about spinal surgery and general anesthesia, (2) to evaluate the level of anxiety, (3) to identify patient factors potentially associated with the level of anxiety, and (4) to describe the characteristics of the anxiety that patients experience during the perioperative period.

Methods

This study was performed in 175 consecutive patients undergoing laminectomy for lumbar stenosis or discectomy for herniated nucleus pulposus under general anesthesia. Demographic data, information related to surgery, and characteristics of anxiety were obtained using a questionnaire. The level of anxiety was assessed using a visual analog scale of anxiety (VAS-anxiety). Patient factors potentially associated with the level of anxiety were investigated using multiple stepwise regression analysis.

Results

Of 157 patients finally included in this study, 137 (87 %) had preoperative anxiety (VAS-anxiety > 0). The mean VAS-anxiety score for spinal surgery was significantly higher than that for general anesthesia (4.6 ± 3.0 vs. 3.2 ± 2.7; P < 0.001). Sex and age were significant patient factors related to the level of anxiety about spinal surgery (P = 0.009) and general anesthesia (P = 0.018); female patients had a higher level of anxiety about spinal surgery, and elderly patients had a higher level of anxiety about general anesthesia. The most helpful factors in overcoming anxiety before surgery and in reducing anxiety after surgery were faith in the medical staff (48.9 %) and surgeon’s explanation of the surgery performed (72.3 %), respectively.

Conclusions

Patients awaiting laminectomy or discectomy feared spinal surgery more than general anesthesia. This study also found that medical staff and surgeons play important roles in overcoming and reducing patient anxiety during the perioperative period.
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