Effect of Preoperative anxiety on Hemodynamic Changes in patients undergoing Cesarean Section under spinal anesthesia

Anxiety is a common problem that can negatively affect outcomes of an operation. The main propose of the present study was to investigate the effects of anxiety on hemodynamic parameters in pregnant women, candidate for elective cesarean section under spinal anesthesia.

Totally, 300 pregnant candidates for elective cesarean section participated in our study. To assess the severity of anxiety, patients were asked to complete DASS questionnaires before surgery and the hemodynamic parameters were recorded before spinal anesthesia, skin incision, uterus incision, and delivery time, at the end of the surgery and in the recovery room.For normal distributed data, t –test was used and to determine whether there is a significant difference between the means of the two groups. Also, repeated measures Analysis of Variance (rANOVA) was run to see how level of blood pressure changes in the different levels of anxiety score.

In the present cross-sectional study, the prevalence percentages of mild, moderate, and extremely severe anxiety in the participants was 8.7 (n= 26), 38.79 (n=115), and 52.5 (n=157), respectively. There was a statistically significant correlation between severity of anxiety and the average of systolic, mean arterial blood pressure, and heart rate.Systolic blood pressure values in the moderate, severe, and extremely severe anxiety levels were found to be 131.3±5.9, 132.2±5.7, and 136±7.4, respectively (P≤0.001) Also, the mean arterial blood pressure values in the moderate, severe, and extremely severe anxiety levels were 99.4±5.8, 99.2±5.9, and 101.6±6.8 (P≤0.01). Futhermore, heart rate increased in these three levels from 82.1±6.3 to 85.5±8.7 and then 91.3±8.9 (P≤0.001).Patients with higher anxiety scores showed higher levels of systolic, mean arterial blood pressure, and heart rate. But it did not seem to have clinical importance.

According to our findings, anxiety results in higher levels of hemodynamic parameters. Also, in parallel with the increase in the severity of anxiety, more hemodynamic changes may be observed in surgery, which had statistical difference although not clinically important.