The effect of preoperative anxiety level on the success of spinal anesthesia in elective caesarean section cases

Objective: The primary aim of our study is to analyze the relationship between the anxiety levels of pregnant women who will undergo spinal anesthesia before the cesarean section and the success of spinal anesthesia and to try to understand the effects of anxiety on anesthesia management. Our secondary aim is to examine the relationship between anxiety and spinal anesthesia complications. Material and Method: Our study, planned as prospective, cross-sectional and observational, was carried out in the Department of Gynecology and Obstetrics of Çukurova University Faculty of Medicine Hospital. It was carried out with 150 patients who would undergo spinal anesthesia due to elective caesarean section, ASA 2 group, 18 years of age and over, who were at a level of consciousness that could fill the anxiety scale and whose consent was obtained for the study, consisting of three groups as medium and high anxiety. After the patients, whose preoperative anxiety levels were evaluated with STAI, were taken to the operation area, routine monitoring was performed and spinal anesthesia was performed. Demographic data of the patients who underwent spinal anesthesia in the operating room, duration of surgery, amount of fluid administered, and side effects of spinal anesthesia were recorded. Pain scores and vital signs were evaluated every 5 minutes before spinal anesthesia, postspinal and during surgery. Interventions (Sedoanalgesia-General Anesthesia) were applied and recorded according to the pain levels of the patients. Results: It was determined that the number of patients receiving sedoanalgesia was statistically significantly higher in the group with severe anxiety than in the moderate and low anxiety groups, and in the group with moderate anxiety compared to the group with low anxiety. However, although the number of patients receiving general anesthesia was higher in the severe anxiety group than in the moderate and low anxiety groups, this difference was not statistically significant between the groups. It was observed that as anxiety severity increased, pain scores and the need for intervention increased. It was determined that there was no statistically significant difference between the patients' anxiety severity and the rate of side effect development. The number of spinal attempts in the group with severe anxiety was statistically higher than the other groups. Conclusion: In our study, it was determined that there was a negative correlation between the level of anxiety in the preoperative period and the success of spinal anesthesia, and as anxiety levels increased, the need for additional intervention increased. It has been shown that patients with high preoperative anxiety have higher pain scores during surgery and thus the need for sedoanalgesia or general anesthesia may increase.