Effect of a Structured Preoperative Educational Video on Maternal Anxiety in Elective Cesarean Section: A Randomized Controlled Trial Using EEG Biomarkers

Objective: Preoperative anxiety is common in patients undergoing elective cesarean section and may worsen perioperative outcomes.This study evaluated whether a structured preoperative educational video (SPEV) reduces maternal anxiety, as measured by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the quantitative electroencephalography (QEEG)-derived theta-beta ratio (TBR).Methods: Ninety primigravida women undergoing elective cesarean section with spinal anaesthesia were randomized to a video group (n = 45; SPEV plus routine counseling) or a control group (n = 45; routine counseling only).APAIS was measured at baseline and 30 minutes before surgery.Parietal TBR was recorded at baseline, 30 minutes before surgery, and 1 hour after surgery.Groups were compared using appropriate non-parametric tests, and the correlation between subjective and QEEG-derived measures was assessed.Results: Baseline characteristics were comparable between groups.At 30 minutes before surgery, APAIS scores were lower in the video group than in the control group [11.0 (9.0-12.0) vs. 14.0 (12.0-16.0);P < 0.001).TBR was also lower before surgery (1.20 vs. 1.90;P < 0.001) and at 1 hour postoperatively (1.20 vs. 1.80;P < 0.001).A positive correlation between APAIS scores and TBR was observed 30 minutes before surgery (P=0.48,P < 0.001).Intraoperative midazolam requirement was lower in the video group (11.1% vs. 33.3%,P=0.021).Conclusion: A SPEV significantly reduced preoperative anxiety in women undergoing elective cesarean section, as demonstrated by both subjective and QEEG-derived measures, and was associated with reduced intraoperative anxiolytic requirements.