Preoperative anxiety, postoperative pain tolerance and analgesia consumption: A prospective cohort study

Background: Anxiety affects the patient’s perception of postoperative pain and causes a significant increase in the consumption of analgesia postoperatively. Objective: This study assesses the relationship between preoperative anxiety, postoperative pain and postoperative pethidine consumption. Methods: A prospective cohort design was used. Data were collected from 100 patients who were undergoing a laparoscopic cholecystectomy at St Joseph Hospital, Jerusalem. Pain-controlled analgesia with pethidine was utilised to manage pain throughout the postoperative period. The visual analogue scale scores and pethidine consumption of all patients were recorded. Findings: Participants’ mean level of pain was higher in the preoperative period (mean visual analogue scale = 1.3) compared with their mean level of pain in the postoperative period (mean visual analogue scale = 0.5). There is a statistically significant difference between the participants’ level of anxiety and postoperative pain level (p < 0.001). Gender, weight, level of education and smoking were predictors of developing preoperative anxiety. Also, gender, smoking and medication were statistically significant predictors of developing postoperative pain. Furthermore, gender, medical history and medication were statistically significant predictors of pethidine consumption postoperatively. Conclusions: The preoperative anxiety reduction intervention should be promoted and implemented as routine care for all surgical patients.