THE ROLE OF PREOPERATIVE ANXIOLYTICS IN REDUCING ANXIETY AND IMPROVING OUTCOMES IN ANESTHESIA
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Abstract
This meta-analysis sought to evaluate how well preoperative anxiolytics work to decrease Anxiety in surgical patients, improve anesthesia outcomes, and manifest enhanced recovery in the postoperative period. The standard response of preoperative Anxiety has both psychological and physiological aspects. This condition negatively affects anesthesia induction, intraoperative stability, and postoperative recovery. The majority of these effects occur because Anxiety activates the sympathetic nervous system. This activation leads directly to several cardiovascular problems that might complicate surgery. Anxiolytics have long been used to counteract these effects, but debate persists regarding their optimal use, dosing, and comparative efficacy across different patient groups. A thorough meta-analysis used data from 50 studies that included 10,500 surgical patients. The studies encompassed randomized controlled trials (RCTs) and high-quality observational studies. The studies were found in databases like PubMed, Cochrane Library, Embase, Scopus, and Web of Science. The primary outcomes of the analysis were preoperative anxiety reduction, anesthesia induction time, intraoperative hemodynamic stability, postoperative pain, opioid consumption, and recovery time. The meta-analysis showed that preoperative anxiolytics substantially lowered anxiety levels (SMD: 0.85, p < 0.001) and caused faster induction times (-10–20%) and lowered anesthetic requirements (-15–25%). Anxiolytic patients had lower amounts of postoperative pain (-20–30%) and reduced opioid consumption (-20–35%). The decrease in opioid-related complications is likely due, in part, to the fact that not every patient receiving an opioid was also receiving as much opioid as would be expected had the patient not been receiving an anxiolytic. Anxiety is a common problem in most surgical patients. The incidence of high anxiety levels in patients undergoing various types of surgery has been reported to range from 10% to 80%. Anxiety not only affects the patient’s mental and emotional well-being but also has adverse effects on surgical outcomes and recovery. Several studies have shown that high levels of preoperative anxiety are associated with an increased incidence of postoperative complications.
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Yasmeen Ahmad Atieh Sobuh
Al Kuwait Hospital, Sharjah, Emirates health services Orchid ID: 0009-0005-9182-4818,
Email: dr.ysobuh@gmail.com
Dina Ziad Al Shaltouni
Al Kuwait Hospital, Sharjah Orchid ID: 0009-0001-4705-8715, Email: Dina.ziyad21@gmail.com
Eman Khouri
Al Kuwait Hospital, Sharjah Orchid ID: 0009-0008-5160-4628, Email: Emansaeed5@outlook.com
Tasnimm Ahmad Alsalim
Emirates health services Orchid ID: 0009-0000-0881-5974, Email: Tasneemsalim954@gmail.com
Alaa Msaddi
Dibba Al-Fujairah Hospital Orchid ID: 0009-0009-8154-212X, Email: alaamsaddi@gmail.com
Ihsan Farooq Akbar
Shifa international hospital Orchid ID: 0009-0002-4768-0966,
Email: ihsanfarooqakbar@gmail.com
Samana batool
Shifa international hospital Orchid ID: 0009-0005-8323-4703,
Email: samanatravels2001@gmail.com