Effectiveness of Preoperative Anxiolytics in Reducing Patient Anxiety Levels: Insights from a Tertiary Care Hospital in Bhawanipatna, Odisha

Abstract

Background: Preoperative anxiety is a prevalent issue among surgical patients, leading to adverse effects on perioperative outcomes. Anxiolytics are often administered to mitigate anxiety, but their effectiveness and impact on perioperative metrics need a thorough evaluation. Methods: A prospective, randomized, controlled trial was conducted at SRM Medical College Hospital, Bhaeanipatna, Odisha, India. A total of 300 adult patients scheduled for elective surgeries were randomized into two groups: an intervention group receiving oral midazolam (0.05 mg/kg) and a control group receiving a placebo. Anxiety levels were measured using the State-Trait Anxiety Inventory (STAI) at baseline, 30 minutes post-intervention, and immediately before anesthesia induction. Perioperative outcomes, including anesthesia induction time, intraoperative hemodynamic stability, extubation time, postoperative nausea and vomiting (PONV), and pain scores, were recorded and analyzed. Results: The intervention group exhibited a significant reduction in anxiety levels compared to the control group at both 30 minutes post-intervention (STAI-S: 35.2 vs. 41.5, p<0.001) and immediately before anesthesia (STAI-S: 33.8 vs. 41.8, p<0.001). Improved perioperative outcomes were observed in the intervention group, including shorter anesthesia induction times (5.3 vs. 5.9 minutes, p=0.002), better intraoperative hemodynamic stability (90.4% vs. 84.2%, p=0.029), faster extubation times (8.4 vs. 9.1 minutes, p=0.015), lower incidence of PONV (15.3% vs. 22.7%, p=0.042), and lower pain scores (3.2 vs. 4.1, p=0.001). Conclusion: Preoperative administration of midazolam effectively reduces patient anxiety levels and improves perioperative outcomes. These findings support the routine use of anxiolytics in the preoperative setting to enhance patient comfort and optimize surgical outcomes.