title: Preoperative anxiety induces no clinically relevant effect on intraoperative nociceptive levels during breast surgery under general anesthesia.
abstract: Anxiety can affect acute and chronic postoperative pain after breast surgery. Nociceptive response during surgery might also be affected by preoperative anxiety even under unconscious state during general anesthesia. The aim of this retrospective study was to investigate nociceptive responses during breast surgery under general anesthesia in patients with or without preoperative anxiety. Patients (n = 45) were divided into a low-anxiety group (n = 25) and a high-anxiety group (n = 20) in accordance with preoperative scores for the State Trait Anxiety Inventory. We performed discriminant analysis to compare nociception during surgery using three intraoperative averaged values: heart rate; systolic blood pressure; and perfusion index. No significant differences in discriminant score were seen between groups (p = 0.10). Although we performed propensity score-matching to reduce the bias due to confounding variables in this retrospective study, there was also no significant difference in levels of nociceptive response between groups (p = 0.06). In conclusion, the level of nociception during breast surgery is not significantly affected by preoperative anxiety.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Hashimoto
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Iwayama
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sano
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Tatara
authors.affiliation: Department of Anesthesiology and Pain Medicine, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 663-8501, Japan. mhirose@hyo-med.ac.jp.
authors.forename: Munetaka
authors.initials: M
authors.lastname: Hirose
mesh_terms: D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D001007:Anxiety / Q000523:psychology*; D001794:Blood Pressure; D005260:Female; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D010149:Postoperative Pain / Q000453:epidemiology*; D012189:Retrospective Studies
keywords: Anxiety; Mastectomy; Nociception