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Preoperative anxiety and its impact on surgical outcomes: A systematic review and meta-analysis

Article scientifique 2025 Anglais

Résumé

Background: Preoperative anxiety is a common phenomenon affecting 60-80% of surgical patients, with potential implications for surgical outcomes. Despite its prevalence, there remains a lack of consensus on its precise effects and optimal management strategies. Objective: This meta-analysis aimed to synthesize current evidence on the impact of preoperative anxiety on various surgical outcomes, including anesthetic and analgesic requirements, delirium, recovery times, and pain. Methods: We conducted a comprehensive literature search and meta-analysis of studies examining the relationship between preoperative anxiety and surgical outcomes. Standardized mean differences (SMD), correlation (COR), and odds ratios (OR) with 95% confidence intervals were calculated. Results: Our analysis revealed significant associations between preoperative anxiety and increased anesthetic requirements (SMD = 0.67, 95% CI: 0.32-1.01) and analgesic requirements (SMD = 0.89, 95% CI: 0.65-1.12). Preoperative anxiety was associated with postoperative delirium in adults (OR = 1.90, 95% CI: 1.11-3.26), unlike the pediatric population. Preoperative anxiety was associated with prolonged time to reach Modified Aldrete Score of 9 (SMD = 0.79, 95% CI: 0.50-1.07) and extubation time (SMD = 0.89, 95% CI: 0.58-1.21). Preoperative anxiety was positively correlated with propofol consumption (STAI-S COR = 0.35, 95%CI: 0.15-0.55). No significant association between preoperative anxiety and postoperative pain was found. Conclusions: This meta-analysis provides evidence for the wide-ranging effects of preoperative anxiety on surgical outcomes. The findings emphasize the need for routine preoperative anxiety screening and the development of targeted interventions. Future research should focus on long-term impacts and the effectiveness of various anxiety management strategies.

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Shebl, M., Toraih, E., Shebl, M., Tolba, A., Ahmed, P., Banga, H., Orz, M., Tammam, M., Saadalla, K., Elsayed, M., Kamal, M., Abdulla, M., Eldessouky, A., Moustafa, Y., Mohamed, O., Aiash, H. (2025). Preoperative anxiety and its impact on surgical outcomes: A systematic review and meta-analysis. https://doi.org/10.1017/cts.2025.6

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Auteur(s)

Mohamed A. Shebl Eman A. Toraih Menna A. Shebl Ahmed Tolba Parisa Ahmed Harshdeep Singh Banga Mohab Orz Mahmoud Tammam Keroles Saadalla Mohamed Elsayed Mennatallah Kamal Mohamed Abdulla Ahmed Ibrahim Eldessouky Yousef Tarek Moustafa Omar Mohamed Hani Aiash

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