Higher Pain Catastrophizing Scores are Associated with Increased Pre-operative Anxiety in Ambulatory Hand Surgery that is not Impacted by Watching a High-Quality Pre-Operative Video

Background Recent studies have shown that online video libraries are poor sources of educational content for patients. Despite this, patients seek videos on the internet to learn about their conditions and treatments, which may increase anxiety prior to surgical procedures. This study tested the hypothesis that watching a high-quality, physician-made video prior to elective hand surgery decreases pre-operative anxiety. Methods Patients undergoing carpal tunnel release (CTR), or trigger finger release (TFR) were randomized to either watch a high-quality video in the pre-operative area or to not watch a video. Patients completed questionnaires before surgery including the State Trait Anxiety Inventory (STAI), quick Disabilities of the Arm, Shoulder, and Hand (qDASH), Visual Analog Score (VAS) pain scale, Patient Activation Measure-13 (PAM-13), and the Pain Catastrophizing Scale (PCS). At 48-72 hours post-operatively, patients were called for a pain check. At 2 weeks following surgery, patients again completed the qDASH and VAS. Results 167 patients were enrolled in the study. 14.4% of patients reported seeking-out videos on the internet pre-operatively. No significant differences were found between the video and control groups. Patients with PCS ≥ 30 reported significantly higher pre-operative STAI, qDASH, and VAS scores compared to patients with PCS < 30. Conclusions Watching a high-quality, physician-made video pre-operatively did not have an impact on pre-operative anxiety. Among all patients, PCS ≥ 30 was associated with significantly higher pre-operative anxiety and significantly worse pre-operative qDASH and VAS scores.