The effect of an auditory distraction on anxiety in ambulatory surgical patients experiencing regional anesthesia.

The effect of an auditory distraction on state anxiety was compared to the effect of no auditory distraction in 20 patients undergoing regional anesthesia in an ambulatory surgical setting. Anxiety was measured using the Spielberger State-Anxiety Inventory. Each patient was tested preoperatively and one hour post-operatively. The experimental group was provided with a choice of one of four "nat u re tapes." The t-statistic was used to evaluate the data. The experimental group showed a statistically significant decline in state anxiety greater than that of the cont rol group with a p-value of 0.025 in the imieant anxiety scores. Also evaluated was the mean difference between the amount of methohexital and fentanyl administered to each group. The results showed that the experimten tal group received a statistically significant amount of methohexital and fentanyl less than the control group with a p-value of 0.025. These results indicate that the provision of an auditory distraction for patients experiencing regional anesthesia is a means of decreasing state anxiety and sedation needs. There are many aspects of surgery that are stress-inducing, one of which may be the sounds of surgery. A stimulating or unusual sound may provoke increased alertness and the activation of the 'fight or flight' neural mechanism. This may result in increased heart rate, blood pressure, skeletal muscle tension, and sensory perception.' Because increased sensory perception and cate-cholamine levels are undesirable in the patient who is about to undergo surgery, it has been the practice to administer intravenous sedation to obtund the stress response. Sedatives routinely used in an ambulatory surgical setting include methohexital, a short-acting barbiturate, and fentanyl, an opioid narcotic. Both are utilized for promoting light sleep in patients experiencing regional anesthesia. The use of other methods not employing medication for the alleviation of psychological stress has been the subject of research since the nineteenth century. Music has been used to calm patients in studies .as early as 1899. The 1940s and 1950s saw a preponderance of research investigating the use of music as a means of soothing surgical patients. Reports have been found in opthalmic, dental and anesthesia literature. All studies noted a decrease in the subjective description of anxiety by the patient as well as decreased sedation needs, although no quantifiable data was obtained. Therefore, the hypothesis of this study was that patients experiencing an auditory distraction (experimental group) will have a greater decrease in anxiety than patients …