Pre-Operative Anxiety Management in Spine Surgery
This poster was presented at the 30th annual Psych Congress, held Sept. 16-19, 2017, in New Orleans, Louisiana.
Introduction: Pre-operative anxiety is experienced by virtually all patients scheduled to undergo spine surgery. Despite being a ubiquitous phenomenon, pre-operative anxiety is an often under-studied influence of surgical outcome that is overlooked during perioperative care. More anxious patients may respond differently to anesthesia, consume more post-operative analgesics, and have longer length of stay.
Methods: An anonymous, cross-sectional study was conducted of spine surgeon members of the organization AO Spine North America to determine surgeons' attitudes for measuring pre-operative anxiety among patients and which management techniques were preferred.
Results and Discussion: Of 68 respondents, the majority were male (n=65, 95.6%), orthopaedic surgeons (n=51, 75.0%), and practicing at an academic medical center (n=38, 55.9%). Most were in practice for 0-29 years (n=49, 72.0%), operated on more than 200 patients per year (n=50, 73.5%), and were attending physicians or faculty (n=60, 88.2%). The majority of surgeons did not ask patients about anxieties (n=45, 66.2%) but discussed it if mentioned by a patient (n=39, 57.4%). Education about the procedure (n=53, 77.9%) and permitting family members to be present (n=35, 51.5%) were preferred by most surgeons to manage pre-operative anxiety. Pre-operative tours (n=29, 42.6%) and visits from the anesthesiologist (n=25, 36.8%) were preferred by a sizable minority. Fostering nurse-patient therapeutic relationships (n=13, 19.1%), anxiolytic medication (n=11, 16.2%), no management (n=11, 16.2%), referral to psychologist or psychiatrist (n=9, 13.2%), cognitive behavioral therapy (n=5, 7.4%), other management technique (n=4, 5.9%), and traditional, complementary, and alternative medicine (n=3, 4.4%) were preferred by few spine surgeons.