Preoperative Anxiety and Its Impact on Hemodynamic Stability and Pain Score in Elective Surgeries
Preoperative Anxiety and Its Impact on Hemodynamic Stability and Pain Score
Keywords:
Preoperative anxiety; APAIS; postoperative pain; hemodynamic stability; heart rate; blood pressure; elective surgery.Abstract
Background: Preoperative anxiety is common among patients undergoing elective surgery and may influence perioperative physiological responses and postoperative pain; however, these relationships vary across surgical populations. Objective: To evaluate preoperative anxiety and its association with perioperative hemodynamic parameters and postoperative pain among adults undergoing elective surgery. Methods: This cross-sectional study included 60 adult patients undergoing elective surgery at Social Security Hospital and Sir Ganga Ram Hospital, Lahore, during early 2025. Preoperative anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS), postoperative pain using the Numeric Rating Scale (NRS), and hemodynamic status using heart rate and blood pressure measurements. Associations were examined using Pearson correlation and multivariable linear regression in SPSS version 26.0. Results: Mean age was 31.37 ± 8.04 years and 71.7% were female. Mean APAIS anxiety and NRS pain scores were 21.35 ± 1.58 and 5.02 ± 0.81, respectively. APAIS anxiety was not associated with postoperative pain (r = −0.031, p = 0.814). NRS scores correlated with heart rate at 1 minute (r = −0.286, p = 0.027), systolic blood pressure at 1 minute (r = 0.401, p = 0.001) and 5 minutes (r = 0.340, p = 0.008), and diastolic blood pressure at 1 minute (r = 0.308, p = 0.017). In multivariable analysis, heart rate at 1 minute (B = −0.284, p = 0.003) and 5 minutes (B = 0.154, p = 0.037) remained associated with pain, whereas APAIS anxiety did not. Conclusion: Preoperative anxiety was not significantly associated with postoperative pain, whereas selected early hemodynamic parameters showed modest associations with pain intensity. Combined psychological, physiological, and direct pain assessment may provide a more comprehensive approach to perioperative evaluation. Keywords: Preoperative anxiety; APAIS; postoperative pain; hemodynamic stability; heart rate; blood pressure; elective surgery.
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