Impact of Preoperative Anxiety on Intraoperative Hemodynamic Changes in Patients Undergoing Elective Surgery: A Multi-Center Study in District Swat, Khyber Pakhtunkhwa

Abstract

Patients frequently experience anxiety before surgery. Significant anxiety is common in patients anticipating surgery, and this worry can cause physiological changes which negatively impact the patient's hemodynamic stability all over the procedure. Patient safety may be jeopardized by variations in blood pressure, heart rate, and cardiac output brought on by this anxiety-induced physiological reaction. To assure optimum organ perfusion while mitigating flaws, it is a prerequisite to sustain uniform blood pressure, heart rate, and cardiac output across surgery. For the surgical team, keeping the patient's hemodynamics before surgery is their main concern. Numerous physiological and psychological impairments brought on by perioperative hemodynamic instability may impede a smooth recovery from surgery, lower quality of life, and raise morbidity and death. Objective The study sought to assess the influence of preoperative anxiety on intraoperative hemodynamics in individuals having elective surgical procedures. A multi-center study was conducted in Malakand Division's Swat district from September to December 2024, in the surgical wards and operating theaters of DHQ Hospital Saidu and (THQ) Hospital Matta. A research study involved 196 patients. Patients with ASA1 and ASA2 physical condition were included in the study. Patients with preexisting hypertension, hypo-tension, a history of cardiac disease, previously identified cognitive impairment, or who had previously undergone a surgical procedure were excluded from the trial.  Patients' preoperative anxiety was assessed using an Urdu-translated version of the Amsterdam preoperative anxiety and information scale (APAIS). This study showed that patients with incredibly high preoperative anxiety levels had considerably higher mean arterial pressure, systolic blood pressure, and diastolic blood pressure outside the operating room, before induction, 5 minutes after induction, 15 minutes, and 25 minutes after induction, in contrast to patients with low levels of preoperative anxiety. This study concludes that patients with High level of preoperative anxiety significantly increased mean arterial pressure, systolic blood pressure, and diastolic blood pressure at critical perioperative intervals. Reducing anxiety levels is critical for limiting these increases and maintaining hemodynamic stability during surgery.