The effect of preoperative anxiety levels on intraoperative hemodynamics and postoperative pain in rhinoplasty surgery

Anxiety and perioperative outcomes in rhinoplasty

Abstract

Background/Aim: Preoperative anxiety is common among surgical patients and may adversely affect perioperative outcomes; however, its influence in patients undergoing rhinoplasty remains insufficiently characterized. This study aimed to investigate the impact of preoperative anxiety levels on intraoperative hemodynamic parameters, postoperative pain intensity, analgesic consumption, postoperative complications, and patient satisfaction in patients undergoing rhinoplasty.

Methods: This single-center, prospective observational study included 150 patients aged 18–60 years with American Society of Anesthesiologists (ASA) physical status I–II who underwent rhinoplasty. Preoperative anxiety was assessed using the State-Trait Anxiety Inventory-State (STAI-I), and patients were stratified into low- and high-anxiety groups. Intraoperative hemodynamic parameters, anesthetic agent consumption, postoperative pain scores, rescue analgesic requirements, postoperative complications, and patient satisfaction were compared between groups.

Results: No significant between-group differences were observed in intraoperative hemodynamic parameters or intraoperative adverse events. Patients in the high-anxiety group had higher postoperative pain scores at most assessed time points and more frequently required rescue analgesia at 4 hours (61.3% vs 44.0%; P = 0.034) and 12 hours (42.7% vs 21.3%; P = 0.005). Postoperative nausea and vomiting (P = 0.048) and shivering (P = 0.019) were more frequent in the high-anxiety group, and patient satisfaction was lower (P = 0.001). Female sex (P = 0.043), younger age (P = 0.005), and occupation (P = 0.031) were significantly associated with anxiety group.

Conclusion: Elevated preoperative anxiety does not appear to influence intraoperative hemodynamic stability in patients undergoing rhinoplasty; however, it is associated with greater postoperative pain, higher rescue analgesic requirements, and lower patient satisfaction. These findings support the clinical value of targeted preoperative anxiety-reduction strategies to optimize perioperative outcomes.