The Effect of Anxiety on Intraoperative and Postoperative Pain in Patients Undergoing Dermatologic Surgery: Learn to Manage

Background: Dermatological surgery has a primary role in dermatologists' daily practice and is usually performed under local anesthesia. This approach required particular attention in patient management before, after, and especially during the surgical procedures. Many people experience anxiety and negative emotions when approaching surgery, and how they feel before surgery affects outcomes after surgery. Objective: The main goals of the present research were to measure and describe anxiety and pain in dermatologic surgery patients and to investigate the anxiety prediction power in predicting surgical pain. Anxiety has been considered at two different moments: before the surgery (preoperative anxiety) and immediately after (postoperative anxiety). Intraoperative as well as postoperative pain have been assessed. The relationships between these two main variables and other factors, including demographics, skin disease history, and vital signs, have been analyzed. Results: The first data concerns the number of patients who experienced preoperative clinical anxiety, which is equal to 150 (29.4%) and has been reduced to 74 (14.5%) regarding postoperative anxiety. Preoperative anxiety, but not postoperative anxiety, significantly contributes to pain prediction. Occupation and previous tumor surgery resulted the main factors associated with preoperative anxiety in intraoperative pain prediction. Diastolic blood pressure, patient occupation, and previous tumor surgery were associated with preoperative anxiety in predicting postoperative pain. Conclusion: Detecting anxiety pre and post-surgery in patients and knowing its relation with pain may allow corrective or palliative measures since anti-inflammatory medication may increase the risk of postoperative bleeding and complications. Patients with features linked to pain perception variation require increased attention to pain management.