The Effects of Preoperative Anxiety on Anesthetic Recovery and Postoperative Pain in Donor Nephrectomy

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IntroductionKidney transplant is the most effective choice of treatment for patients with end-stage kidney failure. About 20-25% of all the kidney transplants performed come from living donors. No prospective study is readily available regarding the effects of preoperative anxiety on anesthetic recovery and postoperative pain in donor nephrectomy. We aimed to investigate the effects of preoperative anxiety on anesthetic recovery and postoperative pain in patients who will undergo donor nephrectomy in this prospective study.Methods48 volunteers who were scheduled for donor nephrectomy, aged between 18‐60 years, with an ASA physical status score of I or II were included in the study. The anxiety levels of the patients were measured using STAI (State Trait Anxiety Inventory) scale during preoperative period. All of the patients were administered general anesthesia following routine monitoring in operating rooms. Morphine PCA was used to provide postoperative analgesia. Correlation of preoperative STAI scores of the patients with demographic data, post anesthesia recovery data and postoperative pain scores were investigated.ResultsSTAI scores of the patients showed no statistically significant correlations with demographics, ASA scores, history of prior surgery, chronic pain, degree of kinship with recipient, educational status, monthly income and smoking status of the patients. STAI I score was found to be significantly correlated with spontaneous respiration time, adequate respiration time, extubation time and the MAS ≥9 time(p<0,01). STAI scores were found to be significantly correlated with the VAS scores of the 30th minute,1st hour,2nd hour,4th hour,8th hour, 12th hour and 24th hour(p<0,05). A significant correlation was established between the STAI I and STAI II scores and the total amount of analgesic administered in 24hours(p<0,05).ConclusionIt is suggested that 38-45% of the patients scheduled for surgery under anesthesia experience anxiety in preoperative period. Effect of anxiety levels on postanesthetic recovery and postoperative pain intensity is still a matter of discussion. Our study showed that patients with high preoperative anxiety levels had a late recovery from anesthesia and high postoperative pain scores. Thus, we suggest that postoperative anxiety levels should be measured preoperatively as adequate planning towards amelioration of excessive anxiety may contribute to anesthetic recovery and postoperative pain intensity.References1. Kälble T, Lucan M, Nicita G, Sells R, Burgos Revilla FJ, Wiesel M. European Association of Urology. EAU guidelines on renal transplantation. Eur Urol. 2005 Feb;47(2):156–66.2. Ali A, Altun D, Oguz BH, Ilhan M, Demircan F, Koltka K. The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy. J Anesth. 2014 Apr;28(2):222–7.3. Kehlet H, Jensen ST, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet: 2006; 371618–125.

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