Assessment and Management of Adult Preoperative Anxiety: A Survey of the Anesthesiologist Perspective

Introduction: Preoperative anxiety often goes unaccounted for in the surgical setting. Given that anesthesiologists are routinely involved in perioperative care, this study was performed to assess anesthesiologists’ views of adult preoperative anxiety assessment and management. Methods: Active members of the American Society of Anesthesiologists (ASA) were sent an online questionnaire. Survey items included demographic information in addition to questions about measurement of preoperative anxiety, management of anxiety, and which entities were allocated responsibility to reduce patient anxiety. Data were collected from February to March 2019. Results: Of 3,661 respondents, most asked their patients about preoperative anxiety (n=2332, 64.3%). The following techniques were supported to reduce preoperative anxiety: pharmacotherapy (n=3205, 91.6%), patient education (n=2493, 71.3%), preoperative anesthesiologist visit (n=2095, 59.9%), family members’ presence (n=1828, 52.3%), preoperative tours (n=660, 18.9%), nurse-patient empathetic interactions (n=622, 17.8%), traditional, complementary, or alternative medicine (n=243, 7.0%), other techniques (n=219, 6.3%), cognitive behavioral therapy (n=107, 3.1%), or referral to a psychologist/psychiatrist (n=44, 1.3%). Discussion: Most anesthesiologists formally assessed preoperative anxiety and indicated a willingness to discuss anxiety if raised by the patient. Most anesthesiologists preferred to administer anxiety medication to reduce preoperative anxiety, but several other techniques were supported