Preoperative anxiety on postoperative pain in craniotomy patients

Aim: This study aimed to determine preoperative anxiety and pain levels in patients who underwent craniotomy and investigate the effects on the development of postoperative acute-chronic pain. 
Materials and Methods: In this prospective, observational study, STAI-I (State-Trait Anxiety Inventory) and STAI-II were used to measure preoperative anxiety levels in a total of 104 patients who underwent craniotomy, and a visual analog score (VAS) was used to determine pain. Demographic data of the patients, ASA (American Society of Anesthesiologists) scores, comorbidities, preoperative and postoperative VAS scores, cause of preoperative anxiety, type, and duration of operation were recorded.
Results: The mean values of STAI tests showed that 31.3% of our patients had mild preoperative anxiety, 58.7% had moderate and 10% had severe preoperative anxiety. In the STAI tests we performed before the operation, the mean values were 44 ± 11.2 for STAI-I and 44.5 ± 9.4 for STAI-II. The causes of preoperative anxiety in patients were determined as surgical operation (35.6%), anesthesia applications (17.3%), insufficient information (11.5%), and the possibility of postoperative pain (3.8%). It was observed that 60.6% of our patients had pain in the preoperative period, 51.9% of patients had acute pain in postoperative the 0th minute, 69.2% in 30th minute, 54.8% in 1st hour, 44.2% in 2nd hour, 34.6% in 24th hour, 22.1% in 48th hour, and 51% of patients had chronic pain in postoperative 6th month. We found a significant relationship between STAI-I and VAS scores at the 48th hour and, between STAI-II and VAS scores at the 2nd, 24th hour, and 6th month (p<0.05). 
Conclusion: It was observed that craniotomy patients mostly had moderate anxiety and moderate to severe pain before the operation, and moderate-severe acute and chronic pain developed after the operation. A significant correlation was found between preoperative anxiety and postoperative pain.