Preoperative Anxiety and Pain Sensitivity, Dr. Tada

Troy Tada, D.O

PGY-4 Resident at RCRMC who will do a Pain Management Fellowship at Rush University upon graduation

Preoperative Anxiety and Pain Sensitivity are Independent Predictors of Propofol and Sevoflurane Requirements in General Anaesthesia

H. K. Kil; W. O. Kim; W. Y. Chung; G. H. Kim; H. Seo; J.-Y. Hong; British Journal of Anesthesia

Psychological factors are thought to drive inter-patient variations in anesthetic and analgesic requirements. This was a cross-sectional study that investigated whether preoperative psychological factors can predict anesthetic requirements and postoperative pain.  One hundred consecutive women completed the Spielberger's State–Trait Anxiety Inventory (STAI) and the pain sensitivity questionnaire (PSQ) prior to their scheduled total thyroidectomy. Target-controlled propofol was administered for induction of anesthesia, and sevoflurane–oxygen–air was given to maintain equal depths of anesthesia, as determined by bispectral index (BIS) monitoring.  This study revealed that patients with higher anxiety scores (state and trait) required greater amounts of propofol to reach light (BIS=85) and moderate (BIS=75) levels of sedation, but only trait anxiety was significantly associated with propofol requirements in reaching a deep level of sedation (BIS=65). The MAC-hour of sevoflurane was significantly correlated only with PSQ scores and postoperative pain intensity was significantly correlated with both STAI and PSQ.  Thus, this study shows that preoperative anxiety and pain sensitivity are independent predictors of propofol and sevoflurane requirements in general anesthesia.