Caumo et al evaluated adults for risk factors associated with postoperative anxiety. This can help identify patients for whom intervention may aid recovery. The authors are from Porto Alegre, Brazil.


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



(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.


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