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Anesth Essays Res. 2019 Jul-Sep;13(3):503-508. doi: 10.4103/aer.AER_59_19.

Assessment of Anxiety in Surgical Patients: An Observational Study.

Author information

Department of Anaesthesiology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India.
Department of Preventive and Social Medicine, All India Institute of Medical Sciences, Patna, Bihar, India.



Preoperative anxiety in surgical patients imposes stress and dissatisfaction. It results in altered neuroendocrine response and various perioperative complications.


This study was conducted to determine the changes in anxiety level and need for information about the anesthetic and the surgical procedures at three different time points before surgery and evaluate the correlating factors.

Settings and Design:

A prospective observational study in a university hospital.

Materials and Methods:

Five hundred adults, American Society of Anesthesiologists Physical Status Class 1 and 2 patients were included in this study. Level of anxiety and need for information were assessed with the Amsterdam Preoperative Anxiety and Information Scale at three time points before the surgery: Evening before surgery in the ward (T1); on the day of surgery, in the preoperative holding area (T2); and in the operating room, after being positioned on the operating table (T3). T-test was applied to compare the mean between two groups, and the Chi-square test for independence of association between two categorical variables. Mann-Whitney-Wilcoxon test was applied to test the equality of distribution between two groups. Kruskal-Wallis test was applied for one-way analysis for comparing median score, and Friedman test was applied for two-way analysis of comparing score among three time points.


Total anxiety score recorded was significantly different over the time period (P = 0.023), with an increasing trend over the time. Need for information did not change significantly over time period.


Preoperative anxiety continues to increase from ward to operation table. The factors responsible are nonmodifiable.


Amsterdam Preoperative Anxiety and Information Scale; Likert scale for scoring; preoperative anxiety

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