Widigdo Rekso Negoro, Sindu Sintara, Annes Rindy Permana, Muhammad Rodli, Reko Priyonggo, Suryanto

Preoperative Anxiety Levels and the Incidence of Postoperative Nausea and Vomiting in Patients Undergoing General Anesthesia

Introduction

Preoperative anxiety levels and the incidence of postoperative nausea and vomiting in patients undergoing general anesthesia. Explore the significant link between preoperative anxiety levels and the incidence of postoperative nausea & vomiting (PONV) in patients undergoing general anesthesia.

Abstract

Postoperative nausea and vomiting (PONV) are common complications after general anesthesia, negatively impacting patient comfort, recovery, and hospital stay. While many factors contribute to PONV, psychological aspects such as preoperative anxiety are often underestimated despite their influence on postoperative outcomes. This study aimed to analyze the relationship between preoperative anxiety levels and the incidence of PONV in patients undergoing surgery under general anesthesia. Using a cross-sectional design, 45 elective surgical patients were assessed for anxiety using the Hamilton Anxiety Rating Scale (HARS), and PONV incidence was recorded within 24 hours post-surgery. Chi-square analysis revealed a significant association between anxiety levels and PONV occurrence (p = 0.002). Among patients with moderate to severe anxiety, 73.3% experienced PONV, compared to only 26.7% among those with mild anxiety. These findings indicate that higher preoperative anxiety increases the risk of PONV. Therefore, integrating psychological assessment and anxiety management into perioperative care is crucial to reducing postoperative complications and improving anesthetic outcomes through a more holistic patient care approach.

Review

This study addresses a clinically important topic by investigating the often-underestimated relationship between preoperative anxiety and the incidence of postoperative nausea and vomiting (PONV) in patients undergoing general anesthesia. The authors correctly highlight PONV as a common complication that significantly impacts patient recovery and satisfaction. By focusing on psychological factors, the research contributes valuable insights into the multifactorial etiology of PONV, moving beyond purely physiological explanations. The aim to analyze this specific relationship is clearly stated and directly relevant to improving perioperative patient care and outcomes. The methodology employed a cross-sectional design, assessing anxiety using the Hamilton Anxiety Rating Scale (HARS) and recording PONV within 24 hours post-surgery in 45 elective surgical patients. The use of a standardized anxiety assessment tool is a strength. The results reveal a statistically significant association between higher preoperative anxiety levels and an increased incidence of PONV (p=0.002), with a stark contrast between patients with moderate-to-severe anxiety (73.3% PONV) and those with mild anxiety (26.7% PONV). While compelling, the relatively small sample size of 45 patients warrants caution regarding the generalizability of these findings, and a cross-sectional design inherently limits the ability to infer direct causation. The findings underscore the critical need to integrate psychological assessment and anxiety management strategies into routine perioperative care. This proactive approach has the potential to not only mitigate PONV but also enhance overall anesthetic outcomes and patient comfort, aligning with a more holistic model of care. For future research, expanding the sample size and employing a prospective, multi-center design would strengthen the evidence base. Furthermore, interventional studies exploring the efficacy of specific anxiety-reduction techniques on PONV incidence, while controlling for other known PONV risk factors, would be highly beneficial in translating these observations into concrete clinical protocols.

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