Printed anesthetic-risk information and perioperative anxiety: a multi-center study

Background: Currently, there is a considerable variation concerning the provision of preanesthetic-risk information, especially potential detrimental adverse outcomes.

Objective: Determine the effects of printed anesthetic-risk information before surgery including patients’ anxiety, refusal of surgery, knowledge perception of adverse events and factors affecting anxiety.

Methods: Patients in a university hospital, a tertiary care hospital, a secondary care hospital, and a neurological institute in Thailand, undergoing low-to-moderate risk surgery were randomly allocated to control group (C) and study group (S), where group C received printed general information in anesthesia, and group S received printed incidences of five anesthetic adverse events as sore throat, nausea/vomiting, tooth loss, not waking up after surgery, cardiac arrest. Spielberger State-Trait Anxiety Inventory Scale (STAIS, STAIT) for anxiety and Visual Analog Scale (VAS) for knowledge perception were recorded before and after information, and after surgery. Numbers of patients who refused surgery and needed anesthetic-risk information in the next surgery were also recorded. STAIS >45 were considered “high anxiety”.

Results: Eight-hundred and twenty-four patients were analyzed (group C: 414, group S: 410). There was no difference in age, sex, ASA physical status, salary, education level, habitat, anesthetic experience and operative risk between groups. STAIS and STAIT, proportion of patients with high anxiety, proportion of patients who refused surgery were not different between groups. Patients in control group needed anesthetic-risk information in the next surgery more than study group (p <0.001). VAS for knowledge about five adverse events in study group were significantly higher than control group (p <0.001). Risk factors by the multivariate analysis included patients with high baseline trait anxiety and low income of less than 10,000 Baht/month.

Conclusion: Printed anesthetic-risk information did not increase anxiety, but increased knowledge perception of the patients.