Pre-Operative Anxiety; Effect of Time to Induce General Anaesthesia After Entrance to Operating Theater

Purpose: Anxiety is an important issue to deal with in patients scheduled for surgery. This study was directed to evaluate the effect of time that pass from the entrance of patients to the theater till induction of anaesthesia. Patients and methods: This study was conducted on fifty adult female patients ASA 1 scheduled for major abdominal surgery. Twenty five patients were placed first on the operating list (group 1) and twenty five were given a time 4-5h later (group 2). Each patient was visited on the evening prior to surgery and again on the morning of surgery. Anxiety was measured at each visit by objective criteria and part 1 of the State-Trait Anxiety Inventory questionnaire and a blood sample was taken at each visit to measure serum cortisol level. Results: The pulse rate, systolic blood pressure and the State-Trait Anxiety Inventory questionnaire scores were higher on the second visit than on the first (p < 0.001) in all patients. This increase was greater in group 2 than in group 1 (p < 0.05). The evening anxiety scores were not correlated with those on the morning visit and could not predict them. Serum cortisol level was significantly higher in second visit than first visit, and that increase was more in group 2 patients (p<0.0001). Conclusion: Pre-operative anxiety on the evening prior to surgery is not a good predictor of anxiety in the immediate pre-operative period. Pre-operative anxiety tends to increase in all patients on the morning of surgery as compared to that on the evening prior to surgery. Also, placing the patient in a late part of the operating list increases the degree of anxiety in the patient awaiting surgery.