Association Between Preoperative Anxiety and Perioperative Haemodynamic Changes in Patients Undergoing Elective Surgery: A Prospective Observational Study

Dr. K. Prathyusha; Dr. Arun Kumar Atakola; Dr. R. Ramya

doi:10.51168/tad9ss44

Authors

Dr. K. Prathyusha Assistant Professor, Department of Anesthesiology, Government Medical College and Government General Hospital, Nirmal, Telangana, India
Dr. Arun Kumar Atakola Assistant Professor, Department of Psychiatry, Government Medical College and Government General Hospital, Nirmal, Telangana, India
Dr. R. Ramya Assistant Professor, Department of Anesthesiology, Government Medical College and Government General Hospital, Nirmal, Telangana, India

DOI:

https://doi.org/10.51168/tad9ss44

Keywords:

Amsterdam Preoperative Anxiety and Information Scale, preoperative anxiety, haemodynamics, heart rate, blood pressure, elective surgery, general anaesthesia

Abstract

Background: Preoperative anxiety is common in patients awaiting surgery and can activate sympathetic responses that alter heart rate and arterial blood pressure during anaesthetic induction.

Objectives: To evaluate the association between preoperative anxiety and perioperative haemodynamic changes in adults undergoing elective surgery.

Methods: This prospective observational study was conducted among patients undergoing elective surgery to evaluate the association between preoperative anxiety and perioperative haemodynamic changes. Preoperative anxiety was assessed before surgery, and haemodynamic parameters were monitored at predefined perioperative intervals to examine their relationship with anxiety levels.

Results: The mean age was 44.7 ± 13.1 years; 56% were male. The mean APAIS anxiety score was 10.3 ± 3.9, and 42% had higher anxiety. Compared with lower-anxiety patients, the higher-anxiety group had greater pre-induction heart rate (89.6 ± 11.8 vs 80.7 ± 10.3 beats/min), systolic blood pressure (137.8 ± 15.6 vs 128.9 ± 14.7 mmHg), and mean arterial pressure (101.6 ± 11.2 vs 95.4 ± 10.1 mmHg). Maximum heart-rate and mean arterial pressure increases were also greater. Anxiety scores correlated with maximum changes in heart rate (r = 0.46) and mean arterial pressure (r = 0.42). These associations remained significant after adjustment for clinical covariates.

Conclusion: Greater preoperative anxiety was associated with more pronounced haemodynamic responses during induction and tracheal intubation.

Recommendations: Routine preoperative anxiety screening and targeted non-pharmacological or pharmacological anxiolytic strategies should be considered in perioperative assessment, particularly for patients at risk of exaggerated cardiovascular responses.

Author Biographies

Dr. K. Prathyusha, Assistant Professor, Department of Anesthesiology, Government Medical College and Government General Hospital, Nirmal, Telangana, India

is an Assistant Professor in the Department of Anesthesiology, Government Medical College and Government General Hospital, Nirmal, Telangana, India. She is actively involved in undergraduate medical teaching, perioperative patient care, clinical anaesthesia, and academic research. Her areas of interest include perioperative medicine, regional anaesthesia, pain management, patient safety, and anaesthesia-related clinical research.
Dr. Arun Kumar Atakola, Assistant Professor, Department of Psychiatry, Government Medical College and Government General Hospital, Nirmal, Telangana, India

is an Assistant Professor in the Department of Psychiatry, Government Medical College and Government General Hospital, Nirmal, Telangana, India. He is involved in undergraduate medical education, clinical psychiatry, patient care, and research activities. His academic interests include anxiety disorders, perioperative psychological factors, behavioural medicine, mental health assessment, and interdisciplinary clinical research.
Dr. R. Ramya, Assistant Professor, Department of Anesthesiology, Government Medical College and Government General Hospital, Nirmal, Telangana, India

is an Assistant Professor in the Department of Anesthesiology, Government Medical College and Government General Hospital, Nirmal, Telangana, India. She is engaged in undergraduate teaching, perioperative care, anaesthesia practice, and clinical research. Her professional interests include perioperative anaesthesia, regional anaesthesia, postoperative outcomes, pain management, and patient-centred anaesthetic care. She serves as the corresponding author of the present study.

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