PREOPERATIVE ANXIETY AND ITS IMPACT ON POSTOPERATIVE PAIN AND RECOVERY IN ELECTIVE ABDOMINAL SURGERY.

Abstract

Preoperative anxiety is frequently observed among patients undergoing elective abdominal surgery and may adversely influence postoperative pain perception and recovery. Heightened anxiety triggers neuroendocrine stress responses that increase analgesic requirements, delay mobilization, and prolong hospital stay.

Objectives: To evaluate the association between preoperative anxiety and postoperative pain intensity, analgesic requirements, and early recovery outcomes in patients undergoing elective abdominal surgery.

Methodology: This prospective study included 100 adults scheduled for elective abdominal surgery over 6 months. Preoperative anxiety was assessed using the Hospital Anxiety and Depression Scale-Anxiety (HADS-A), and patients were categorized into low and high anxiety groups using a cutoff ≥8. Postoperative pain was measured using the Visual Analogue Scale (VAS) at 6, 12, and 24 hours. Opioid requirements, time to ambulation, and hospital stay were recorded. Data were analyzed using SPSS 24, with t-tests and chi-square applied; p≤0.05 was considered significant.

Results: The mean age of participants was 42.8 ± 12.6 years. Preoperative anxiety was identified in 46% of patients. Those with high anxiety reported significantly higher VAS pain scores at 6 hours (7.1 ± 1.4 vs. 5.6 ± 1.2; p=0.001), 12 hours (6.4 ± 1.3 vs. 4.8 ± 1.1; p=0.003), and 24 hours (5.3 ± 1.2 vs. 3.9 ± 1.0; p=0.005). Opioid consumption was also higher (p=0.02). Anxious patients experienced delayed ambulation (17.2 ± 3.8 vs. 13.9 ± 3.2 hours; p=0.01) and longer hospital stays (3.8 ± 1.1 vs. 2.9 ± 0.9 days; p=0.01).

Conclusion: Preoperative anxiety independently predicts higher postoperative pain and delayed recovery. Routine anxiety screening and preoperative counseling may improve postoperative outcomes and should be integrated into perioperative care.