Preoperative anxiety has a negative effect on palinesthesia and postoperative analgesia in patients undergoing laparascopic cholecystectomy

Abstract

Objective To investigate the effect of preoperative anxiety on postoperative pain control and palinesthesia in patients undergoing laparoscopic cholecystectomy. Methods A total of 82 patients undergoing laparoscopic cholecystectomy were enrolled. Beck's anxiety inventory(BAI) was administered to the patients: patients with anxiety were included in the group anxious patient (n=32) and patients without anxiety were enrolled in the group control(n=50). Duration of surgery, duration of anesthesia, adverse effects and the time for the modified Aldrete score to reach 9 were recorded. During the postoperative period, patient-controlled analgesia with fentanyl was used for pain control. VAS scores, fentanyl consumption and extra analgesic requirements were recorded. Results Among all patients, 32(39%) patients had preoperative anxiety according to preoperative score of BAI. Compared with the group control, the time for the modified Aldrete score to reach 9 was seen as significantly longer[(5.0±1.4) s vs (6.3±1.5) s(P<0.05)], and more postoperative side effects were determined in the group anxious patient. Also in the group anxious patient postoperative VAS score[4 h: (3.5±0.7) vs (2.6±1.0), 8 h: (3.3±0.9) vs (2.2±0.8), 12 h: (3.1±0.5) vs (2.4±0.6)](P<0.05) and fentanyl consumption were remarkably higher, and more lornoxicam was needed(P<0.05). Preoperative score of BAI exhibited a positive correlation with VAS scores after surgery(8 h: r=0.422, 12 h: r=0.526) (P<0.05). Conclusions In this study, preoperative anxiety negatively affects recovery from anesthesia and control of postoperative pain. In this group anxious patient, the increased need for postoperative analgesia must be adequately met. Key words: Anxiety; Cholecystectomy; Palinesthesia; Postoperative analgesia