Decreasing Preoperative Anxiety in Patients with Newly Available Multimodal Approaches-A Narrative Review.
Journal of clinical medicine – April 24, 2025
Source: PubMed
Summary
Anxiety before surgery affects 8 in 10 patients, but innovative approaches are changing this. A combination of medication and therapy shows promising results in reducing patient stress. Anti-anxiety agents provide quick relief, while perioperative care teams now use music, virtual reality, and psychotherapy. Informed consent processes have evolved to be more reassuring and comprehensive.
Abstract
Preoperative anxiety affects approximately 80% of adult patients; thus, identifying patients with excessive anxiety and implementing appropriate interventions can significantly reduce the risk of deterioration during the perioperative period. This narrative review presents current knowledge about pharmacological and nonpharmacological methods for reducing preoperative anxiety. Commonly used pharmacological options include benzodiazepines, ketamine, or fentanyl. Antidepressants have also been shown to be effective in alleviating symptoms, but they typically require four weeks to take effect. Establishment of supportive relationships with medical staff to help patients express their feelings have been shown to have a positive impact on anxiety reduction. Other nonpharmacological methods include the provision of information through informed consent forms, video materials, virtual reality, or the use of psychotherapeutic interventions such as breathing techniques, music therapy, or cognitive-behavioural therapy. Some studies suggest that essential oils may have a role in reducing perioperative anxiety. Nonpharmacological interventions can be used in patients of different ages. An increasing number of researchers advocate for a holistic approach that integrates less invasive and cost-effective interventions with conventional medicine. While various interventions have been proposed to manage preoperative anxiety, more research is needed to establish the most effective and feasible interventions for different patient populations.