Pharmacological Interventions to Reduce Preoperative Anxiety among Patients with Major Surgery

Abstract

Introduction: Stress and anxiety are negative feelings which can antagonistically impact the surgical outcomes and additionally influence the patient's recovery. This review aimed to summarize the pharmacological interventions used to control of preoperative anxiety.
Methods: An electronic search in MEDLINE and EMBASE was done using a combination of keywords. The search resulted in 64 studies, which were screened for eligibility criteria such as clinical trial design, English language, and human studies. After exclusion of ineligible, duplicated and review studies, the full text of the eligible studies were screened and the data were extracted. The characteristics for which data were collected included sample size, age of patients, type of surgery, medications used to reduce anxiety, dose and regime of medications, effect of reduction in anxiety. The findings of the review summarized in table of inclusion studies.
Results: The search of the literature, after exclusion of ineligible studies, revealed 14 studies met the inclusion criteria. Included studies aimed to investigate, from randomized controlled trials, the pharmacological interventions for control of preoperative anxiety. The total number of included patients was 983, of them adult subjects was 556 with the age range of 18-70 years and 427 children with the age range of 1-11 years. Some of the included placebo-controlled trial while active control were recruited in other studies. Regarding the main outcome which is the reduction of preoperative analgesia reported in many included studies while no difference appeared in other studies.
Conclusions: Benzodiazepines remain the medication of choice for the treatment of preoperative anxiety. However, many cautions should be taken in using preoperative medications among specific groups of patients such as hypersensitive reaction or physical dependence on the prescription..