Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Jun 19, 2024; 14(6): 930-937
Published online Jun 19, 2024. doi: 10.5498/wjp.v14.i6.930
Correlation between pre-anesthesia anxiety and emergence agitation in non-small cell lung cancer surgery patients
Fen Yan, Li-Hua Yuan, Xiao He, Kai-Feng Yu
Fen Yan, Li-Hua Yuan, Xiao He, Kai-Feng Yu, Department of Anesthesiology, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430000, Hubei Province, China
Author contributions: Yan F and Yu KF conceived the project and wrote the manuscript; Yuan LH and He X acquired and analyzed the data; all authors contributed to the article and approved the submitted version.
Institutional review board statement: This study was reviewed and approved by the Wuhan Pulmonary Hospital Institutional Review Board.
Informed consent statement: All participants have signed informed consent forms.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Data sharing statement: The anonymous data used in this study can be obtained from the corresponding author upon request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai-Feng Yu, MM, Professor, Department of Anesthesiology, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, No. 28 Baofeng Road, Qiaokou District, Wuhan 430000, Hubei Province, China. yukf2213@163.com
Received: March 25, 2024
Revised: May 8, 2024
Accepted: May 16, 2024
Published online: June 19, 2024
Processing time: 85 Days and 23.8 Hours
Abstract
BACKGROUND

Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery. Emergence agitation (EA) is a common complication of general anesthesia that may increase patient discomfort and hospital stay and may be associated with the development of postoperative complications. Pre-anesthetic anxiety may be associated with the development of EA, but studies in this area are lacking.

AIM

To determine the relationship between pre-anesthetic anxiety and EA after radical surgery in patients with non-small cell lung cancer (NSCLC).

METHODS

Eighty patients with NSCLC undergoing surgical treatment between June 2020 and June 2023 were conveniently sampled. We used the Hospital Anxiety and Depression Scale’s (HADS) anxiety subscale (HADS-A) to determine patients’ anxiety at four time points (T1-T4): Patients’ preoperative visit, waiting period in the surgical waiting room, after entering the operating room, and before anesthesia induction, respectively. The Riker Sedation-Agitation Scale (RSAS) examined EA after surgery. Scatter plots of HADS-A and RSAS scores assessed the correlation between patients’ pre-anesthesia anxiety status and EA. We performed a partial correlation analysis of HADS-A scores with RSAS scores.

RESULTS

NSCLC patients’ HADS-A scores gradually increased at the four time points: 7.33 ± 2.03 at T1, 7.99 ± 2.22 at T2, 8.05 ± 2.81 at T3, and 8.36 ± 4.17 at T4. The patients’ postoperative RSAS score was 4.49 ± 1.18, and 27 patients scored ≥ 5, indicating that 33.75% patients had EA. HADS-A scores at T3 and T4 were significantly higher in patients with EA (9.67 ± 3.02 vs 7.23 ± 2.31, 12.56 ± 4.10 vs 6.23 ± 2.05, P < 0.001). Scatter plots showed the highest correlation between HADS-A and RSAS scores at T3 and T4. Partial correlation analysis showed a strong positive correlation between HADS-A and RSAS scores at T3 and T4 (r = 0.296, 0.314, P < 0.01).

CONCLUSION

Agitation during anesthesia recovery in patients undergoing radical resection for NSCLC correlated with anxiety at the time of entering the operating room and before anesthesia induction.

Keywords: Non-small cell lung cancer, Operative treatment, Anesthesiology department, Pre-anesthetic anxiety, Emergence agitation, Correlation study

Core Tip: This study explored the relationship between anxiety and awakening agitation at four time points (patients’ preoperative visit, waiting period in the surgical waiting room, after entering the operating room, and before anesthesia induction), and clarified that emergence agitation in patients undergoing radical surgery for non-small cell lung cancer was related to anxiety at the time of entering the operating room and before anesthesia induction. This finding provides new insights into the management of preoperative anxiety and prevention of postoperative agitation, which can help improve postoperative recovery.