The relationship between preoperative anxiety level and postoperative pain level in patients planned for elective cesarean section under spinal anesthesia

Introduction Interindividual variability in degree of pain and response to analgesic treatment creates a considerable clinical challenge in acute postoperative care after cesarean delivery. Accurate prediction and targeted treatment of women who will experience severe postcesarean delivery pain might reduce the persistent effects associated with severe pain. It has been stated that the variables in the preoperative period are effective on postoperative pain. This study aimed to evaluate the relationship between the level of anxiety in the preoperative period and the pain in the acute postoperative period in patients undergoing elective cesarean section. Material and methods The study was conducted with 132 patients who underwent elective cesarean section between November 2019 and April 2020. Vital signs and patient demographics were obtained and recorded as part of the usual preoperative assessment. In preoperative period, anxiety levels of the patients were evaluated with the State-Trait Anxiety Inventory (STAI) scale. All patients received subarachnoid anesthesia with intrathecal hyperbaric bupivacaine 10 mg and fentanyl 10 µg. In the postoperative period, pain intensity (10 point VAS) when patients needed analgesia, first pain time, and first analgesia time were recorded. Results The average age of the patients is 31.2 ± 5.6 years. The mean VAS value for postoperative pain was 5.1 ± 2.3. None of the STAI scores did not correlate with patients' level of education. There was no significant relationship between STAI-S and VAS, time of first pain and time of first analgesia. However, STAI-T corelated with time of first pain, negatively (p=0.022). Moreover, patients with STAI-T≤40 had higher VAS values (p=0.024), earlier time to first pain (p=0.044) and time to first analgesia (p=0.040) compared to patients with STAI-T>40. Conclusion Preoperative trait anxiety level is related wtih postoperative pain level. In patients undergoing elective cesarean delivery, the patient's current surgical anxiety was not effective on pain.