Предоперационная тревожность в офтальмохирургии: распространенность и факторы риска: проспективное наблюдательное исследование

INTRODUCTION: Refractive surgery involves the patient's eyes being in a fixed position, which the surgeon cannot control. If a patient is experiencing psychological or emotional stress during this time, it can lead to intraoperative complications, such as loss of vacuum. OBJECTIVE: To assess the anxiety level of adult patients before laser vision correction surgery, to determine risk factors and the impact of preoperative anxiety on the course of surgery. MATERIALS AND METHODS: Patients (n = 339) who underwent vision correction surgery were asked to fill out the Spielberger-Khanin questionnaire to assess preoperative anxiety and a research questionnaire including the following items: gender, age, history of surgical interventions. The duration of the operation, the need for procedural sedation with analgesia, and the presence of adverse events such as arterial hypotension and postoperative nausea and vomiting were also taken into account. RESULTS: 185 patients (54.5 %) had a high level of anxiety. Predictors of a high level of preoperative anxiety have been identified. When assessing the correlation of anxiety with the duration of surgery, a strong positive relationship was found (r = 0.7589, p < 0.0001). The sensitivity of situational anxiety regarding the need for procedural sedation with analgesia is 96.4 %, and the specificity is 78.3 % (AUROC = 0.913; p < 0.0001). Sensitivity for predicting adverse events was 72.2 %, specificity 63.2 % (AUROC = 0.705 p = 0.0034). CONCLUSIONS: There was a high level of preoperative anxiety before surgery. Risk factors for high levels of anxiety include a history of eye surgery, female gender, vegetative vascular dystonia, hypothyroidism, anxiety disorder, obesity, chronic cholecystitis, and lack of prior surgical training. A strong positive relationship was found between the level of situational anxiety and the duration of surgery and the need for procedural sedation with analgesia and adverse events.