Abstract

Objectives: To compare the anxiety level of patients who have received pre-operative counselling, tablet  Diazepam 10 mg previous night of surgery and patients who have neither received any anxiolytic medication nor  pre-operative counselling, To monitor preoperative, intraoperative and post-operative pulse rate, blood pressure  of study groups, to note the length of hospital, stay of the patient post operatively. Methods: Three hundred ASA 1/2 patients admitted for elective surgical procedure requiring anesthesia were  assigned into one of the three groups. •Group C =Pre-Operative counselling done, •Group D =Tab. Diazepam 10mg HS 1day prior to Surgery. •Group NC= Non-counselled patients.The study group C patients are counselled in respects of the type of anesthesia, operative procedure. The study group D is given tab. Diazepam 10 mg a night  prior to surgery. The study group NC is neither given pre-operative counselling nor given tab Diazepam. They are  non-counselled group.Data is collected by means of a questionnaire given to the patients in the form of Spielberger’  state – Trait Anxiety Inventory scale (STAIS). The patients anxiety levels were measured.  Result: In our study the three groups had high STAIS score before surgery with normal baseline haemodynamic  values. Patients who received counselling and tab. Diazepam pre operatively were haemodynamically stable  during intra and post operative period and had a low to moderate anxiety score during post operative visit as  compared to group NC which neither received pre operative counselling nor tab. Diazepam and had unstable  pulse rate, systolic blood pressure, diastolic blood pressureduring intra and post operative period. Their STAIS  score after surgery remained high as compared to their pre operative score. Group C and D had mean hospital stay  of 4.04 ± 0.65 to 4.75 ± 0.97 days which is less than group NC with mean hospital stay was 6.55 ± 0.67 days. Conclusion: Lack of information related to possible pre-operation and post-operation conditions increases  the anxiety level of patients. This causes intra operative instability in haemodynamic, post-operative emotional  problems and thus increase hospital stay. Personal interview and previous night anxiolytic (Tab. Diazepam) are  good at alleviating the anxiety throughout the perioperative period. Transfer of knowledge and information  through counselling to be more effective in decreasing the anxiety and apprehension. It is more helpful in patients  who are illiterate and who do not actively participate in the interview. Hence, a personal interview along with an  anxiolytic previous night of surgery is a good option in allaying the anxiety. This study has critically examined and found that preoperative patient education significantly reduces intra  operative haemodynamic instability, postoperative anxiety and length of hospital stay. This study strongly  recommends preoperative patient education so as to have better outcome, less morbidity and less healthcare cost. 

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