The Effects of Preoperative Anxiety on Intravenous Sedation. RESULTS

In: Health

15 Sep 2009

State and trait anxiety scores have been analyzed for the 25 patients in this study. As expected, state and trait anxiety correlated with one another (r = 0.48, P = .016). In this study, 9 of the 25 patients were found to have a high level of anxiety before their surgical procedure (state anxiety score >50). The average state anxiety score was 44.36 (range, 29-64), whereas the average trait anxiety score was 37.12 (range, 29-56). State and trait anxiety were further analyzed to assess the potential relationship among individual subjects’ anxiety, the total dose of propofol administered in the procedure, and the patients’ degree of intraoperative movement.

Total doses of sedative medications were also recorded in all subjects. The average doses of fentanyl and midazolam were calculated before the procedure on a per weight basis and varied little among subjects. No additional doses of fentanyl were administered during any procedure, and only one patient required an additional dose of midazolam. Because of the large variability of dose of propofol administered, we therefore calculated total average dose administered to compare the doses of subjects, accounting for patient weight and time of procedure. The average dose of propofol administered was 0.0822 mgAg per minute (range, 0.037-0.185 mgAg per minute). order levitra professional

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Figure 1. State anxiety and trait anxiety demonstrated as continuous predictors of an increase in total dose requirement of propofol to maintain a clinically acceptable level of sedation.

In one analysis, patients with a high level of preoperative anxiety (state anxiety score ^50) required a greater amount of propofol to maintain a clinically acceptable level of sedation (P = .0273) when compared with patients with less preoperative anxiety. We have also noted (Figure 1) that an increased level of state anxiety serves as a predictor for an increased total dose of propofol required to maintain a clinically acceptable level of sedation (r2 = 0.285, P = .0060), a finding that was also seen in patients with an increased level of trait anxiety (r2 = 0.233, P = .0146).

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Figure 2. State and trait anxiety as continuous predictors of increased intraoperative movement. Only trait anxiety serves as a significant predictor of increased intraoperative movement.

In analysis of the amount of intraoperative movement, the scores of movement of each subject were averaged and compared. The average amount of intraoperative movement was 1.77 (range, 1-3.3) of 5. Patients with a high level of preoperative anxiety (state anxiety score >50) were found to have a greater degree of average intraoperative movement (P = .037). As is demonstrated in Figure 2, an increased level of trait anxiety was also seen as a predictor of an increased degree of average intraoperative movement (r2 = 0.342, P = .0022). An increased level of state anxiety did not serve as a significant predictor of increased intraoperative movement (r2 = 0.143, P = .0621).
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