The impact of pre-operative anxiety on post-operative sore throat in tympanoplasty

Introduction and Objective: Tympanoplasty is a surgical procedure in which a defect in the tympanic membrane due to chronic otitis media and its sequelae is repaired with a graft. Anxiety is defined as an uneasy feeling of uncertain origin and has a negative impact on the operative process and postoperative recovery. Postoperative sore throat (POBA) is a complication of intubation. Complications such as hoarseness, dysphagia and cough may be observed. In our study, we aimed to evaluate the relationship between preoperative anxiety level and POBA and other intubation complications in tympanoplasty operations. Materials and Methods: Seventy-six patients scheduled for elective tympanoplasty under general anaesthesia in the operating room of Balıkesir University Health Practice and Research Hospital were included in the study. Sociodemographic data were recorded. Preoperative STAI-S/T was evaluated according to the STAI-S/T scale; STAI-S ≤45 was considered as Group D, and STAI-S >45 was considered as Group Y. No sedative drugs were used for premedication. Standard monitoring was performed; HR, NIBP, SpO2 values were recorded. Endotracheal intubation was performed by applying standard anaesthesia induction protocol. Paracetamol 10 mg/kg and tramadol 1 mg/kg were administered before the operation was terminated. POBA, nausea-vomiting, cough and hoarseness scores were recorded at 0, 2, 4, 12 and 24 hours. Dexketoprofen 50 mg IV was used as rescue analgesia to patients with NRS>4. Results: According to statistical analysis, no significant difference was found between the groups in terms of demographic data (p>0.05). NRS scores evaluated at 0, 2, 4, 12 and 24 hours postoperatively were significantly higher in Group Y (n=26) compared to Group D (n=50) (p<0.05). However, there was no correlation between preoperative anxiety level and POBA between the groups. According to logistic regression analyses, the effects of STAI-S variable alone on NRS values were significant (p<0.05). There was no difference between the groups in terms of opioid and rescue analgesic consumption. Conclusion: Logistic regression analyses performed in our study showed that preoperative anxiety level was one of the independent variables determining postoperative sore throat. Keywords: Tympanoplasty, Anxiety, Anaesthesia, Postoperative Sore Throat