Impact Of Structured Anesthesia Information Sheets On Preoperative Anxiety In Patients Undergoing Lower Abdominal Surgery: A Randomized Controlled Trial

Preoperative anxiety is a common phenomenon that significantly impacts patient outcomes and recovery trajectories. The anxiety primarily stems from fears related to the outcome of the surgery, the surgical process itself, and concerns over anesthesia. This heightened state of apprehension can lead to various physiological responses including increased heart rate and blood pressure, which may complicate anesthetic management and affect surgical outcomes. Effective preoperative counseling has been shown to mitigate these anxieties, but the mode and structure of this counseling can vary widely.1,2,3

 

Structured information delivery, using tools such as anesthesia information sheets, has been hypothesized to provide better outcomes in reducing preoperative anxiety compared to conventional verbal counseling. These structured sheets aim to provide consistent, comprehensive information that can be referred back to as needed, potentially alleviating anxiety more effectively than the transient nature of verbal advice.4

The present study, conducted at the Department of Anesthesiology, SMS Medical College and its affiliated hospitals, aimed to evaluate the impact of structured anesthesia information sheets versus conventional verbal counseling on preoperative anxiety among patients undergoing lower abdominal surgeries. This randomized controlled trial addressed a critical gap in anesthetic practice by quantitatively measuring the efficacy of two different counseling approaches on patient anxiety, assessed through Visual Analogue Scale-Anxiety (VAS-A) scores.5,6,7

 

With an increasing emphasis on patient-centered care, understanding the role of patient education through preoperative counseling as an intervention to improve surgical outcomes becomes paramount.8 This study’s findings are intended to contribute to the optimization of preoperative protocols that can significantly enhance patient experiences and outcomes in surgical settings.

 

The study included two groups of 35 patients each, undergoing lower abdominal surgery. Group A received preoperative counseling using a structured anesthesia information sheet, while Group B was provided with conventional verbal counseling. The primary outcome measured was the change in preoperative anxiety, quantified using the Visual Analogue Scale for Anxiety (VAS-A).

 

Demographic and Baseline Characteristics The demographic analysis revealed no significant differences between the two groups regarding age, sex, weight, educational qualifications, marital status, and ASA grades, ensuring comparability. The mean age in Group A was 35.46±7.66 years and in Group B was 35.80±7.39 years, with a p-value of 0.953, indicating statistical nonsignificance.

 

Anxiety Outcomes Pre-counseling VAS-A scores were comparable between the two groups (Group A: 46.86±13.88, Group B: 45.43±11.20; p=0.637). Post-counseling results showed a significant reduction in anxiety levels in Group A (27.43±7.41) compared to Group B (31.14±5.83), with a p-value of 0.023. The intra-group comparison further highlighted a statistically significant reduction in anxiety within each group (p<0.001 for both groups), with Group A showing a greater decrease.

 

Surgical Anxiety Outcomes Similarly, anxiety related to surgery measured through VAS scores also showed significant improvement post-counseling in Group A compared to Group B, with post-counseling scores of 22.00±5.84 in Group A and 26.11±2.39 in Group B (p=0.0003). The decrease from pre-counseling to post-counseling was also statistically significant within each group.

 

These results underscore the effectiveness of structured anesthesia information sheets in reducing preoperative anxiety more significantly than conventional verbal counseling. The findings advocate for an integration of structured informational tools in preoperative counseling protocols to enhance patient care and reduce anxiety-related complications in surgical settings.

 

TABLE 1: AGE DISTRIBUTION OF PATIENTS

Age Group	Group A (n=35)	%	Group B (n=35)	%
18-30 years	8	22.86	7	20.00
31-40 years	17	48.57	18	51.43
>40 years	10	28.57	10	28.57
Total	35	100.00	35	100.00
Mean±SD	35.46±7.66		35.80±7.39
P value	\multicolumn{4}{c	}{0.953 (NS)}

 

TABLE 2: VAS SCORE OF ANXIETY FOR ANESTHESIA

Condition	Group A (Mean±SD)	Group B (Mean±SD)	P value
Pre-counseling	46.86±13.88	45.43±11.20	0.637 (NS)
Post-counseling	27.43±7.41	31.14±5.83	0.023 (S)
Difference in VAS-A Score	19.43±9.68	14.29±10.79	<0.001 (S)

 

TABLE 3: VAS SCORE OF ANXIETY FOR SURGERY

Condition	Group A (Mean±SD)	Group B (Mean±SD)	P value
Pre-counseling	41.14±12.07	40.46±7.32	0.775 (NS)
Post-counseling	22.00±5.84	26.11±2.39	0.0003 (S)
Difference in VAS Score	19.14±9.81	14.35±8.07	0.023 (S)

Figure 1: Bar Graph of Age Distribution in Groups A and B

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Figure 1 Age Distribution

Group A

Group B

 

This randomized controlled trial demonstrated that structured anesthesia information sheets significantly reduce preoperative anxiety compared to conventional verbal counseling among patients undergoing lower abdominal surgery. This finding aligns with existing literature emphasizing the importance of effective communication in medical settings, particularly in the preoperative phase where anxiety can adversely affect both patient experience and surgical outcomes.9

 

The substantial reduction in VAS-A scores post-counseling observed in Group A supports the hypothesis that structured information, which patients can review and digest at their own pace, may be more reassuring than traditional verbal methods. The ability to revisit the structured information may help in alleviating anxiety by providing a sense of control and preparedness, which is less achievable through a single verbal interaction. This aspect of the study underscores the role of information retention in anxiety management, suggesting that the permanence of written information could be crucial in preoperative settings.10,11

 

Furthermore, the significant improvements in anxiety levels about surgery itself in Group A suggest that the effects of structured information extend beyond general preoperative anxiety to include specific anxieties about the surgical process. These findings are particularly relevant in the context of Enhanced Recovery After Surgery (ERAS) protocols, which prioritize reducing preoperative stress as a key component of optimizing surgical outcomes.12

However, it is noteworthy that while the differences in anxiety reduction between the two groups were statistically significant, the clinical significance should be interpreted with consideration of individual patient contexts. The study’s implications for practice involve integrating structured counseling tools into routine preoperative care, potentially standardizing this as part of ERAS protocols across surgical disciplines.13

 

Limitations of this study include its focus on a single surgical category and a specific hospital setting, which may affect the generalizability of the findings. Future research could explore the application of structured information sheets across different types of surgeries and diverse demographic groups to validate and expand on these results.

 

CONCLUSION

 

The study conclusively found that structured anesthesia information sheets are more effective than conventional verbal counseling in reducing preoperative anxiety among patients undergoing lower abdominal surgery. This suggests a clear benefit to incorporating structured informational tools into preoperative practices, potentially improving patient outcomes by alleviating anxiety. Such practices not only support clinical care improvements but also enhance patient satisfaction and may contribute to faster recovery and better overall health outcomes.