Ramsay identified a number of factors associated with pre-operative anxiety. A patient with one or more of these risk factors may benefit from an intervention to address the specific fears. The author is at London Hospital in London, England.


Commonly expressed fears by patients:

(1) fear of death or not waking up after surgery

(2) fear of masks or needles used during induction

(3) waking up during the middle of the operation

(4) feeling pain during the operation

(5) talking while under general anesthesia (being indiscreet)

(6) post-operative vomiting

(7) post-operative pain

(8) miscellaneous fears


Other concerns:

(1) pregnant women concern about the effects of anesthetics on infants

(2) impact of illness on family members

(3) economics


Additional factors affecting the level of anxiety before surgery:

(1) age of the patient (typically greatest in teenagers and middle aged patients)

(2) previous experience with anesthesia and surgery

(3) anxious personality

(4) rapport and trust with anesthesiologist and surgeon

(5) seriousness of the operation and what may be found at surgery

(6) perceived benefit from the operation



• A preoperative interview between the patient and the anesthesiologist can help allay some concerns, and is better than having the acquaintance made moments before the induction.


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