Patients studied:
(1) adults (18 to 60 years of age) admitted for elective surgery
(2) ASA status I, II or III
Factors associated with increased risk of postoperative anxiety:
(1) ASA status III (odds ratio 1.48)
(2) history of smoking (odds ratio 1.62; I wonder if this could be nicotine withdrawal)
(3) moderate to intense post-operative pain (odds ratio 2.62)
(4) high pain rating index (odds ratio 2.35)
(5) minor psychiatric disorders (odds ratio 1.87)
(6) pre-operative state anxiety (odds ratio 2.65)
(7) negative (feelings of hopelessness) future perceptions (odds ratio 2.20)
Factors decreasing risk of postoperative anxiety:
(1) neural block anesthesia
(2) systemic multimodal analgesia
(3) neuroaxial opioids
Observations:
(1) Several of the risk factors (smoking, minor psychiatric disorder, pre-operative anxiety, depressive outlook) indicate a pre-existing anxiety-depressive disorder.
(2) The factors reducing risk are those that would reduce post-operative pain.
