Influence of Preoperative Anxiety Level on Postoperative Pain After Cardiac Surgery

Introduction Preoperative anxiety is generally neglected in evaluation of cardiac surgery patients due to various reasons including insufficient literature and lack of simple assessment tool. In addition, association between anxiety and postoperative complications including pain has been scarcely studied.Present study was designed, to assess preoperative anxiety levels in all patients coming for cardiac surgery and then evaluate the effect of different levels of anxiety on postoperative pain scores. Methods This prospective cohort study was conducted in a single university hospital, from March 2018 to December 2019. 100 consecutive cardiac surgery patients between the ages of 18-65 year were enrolled in this study. Level of preoperative anxiety ( assessed by State Anxiety Inventory) and its effect on postoperative pain and morphine consumption was assessed. Results The average age of the patients was 58.24±10.03 year in which 68% were male and 32% female. Preoperative mild anxiety was observed in 64% patients and moderate to severe anxiety in 36% patients. Post-operative mean pain score was significantly high in moderate to severe anxiety group as compared to mild anxiety group [Mean pain difference =1.64 (95%CI: 1.38-1.89) p=0.0005], [Mean pain difference =0.51 (95%CI: 0.29-0.73) p=0.0005] at 12 hour and 24 hour respectively. Intraoperative and postoperative morphine consumption was significantly high in patients with moderate to severe anxiety group. Conclusions Patients with moderate to severe anxiety before cardiac surgery experienced higher pain scores at post-operative period which is significantly different from mild anxiety group. Intraoperative and postoperative analgesic requirements were also significantly increased.