The patientholds their eyes wide open, transfixed with fear as the anesthesiologistswiftly motions a face mask forward (see ). Numbly watching, the patient has a vividrecollection of the doctor mentioning “gas mixture” and “sevoflurane” from 2 days before. “This is it, it’s happening,” ruminates the patient,anxiously preparing as the mask inches closer. Two more doctors loom over,gently whispering to the patient “count down from 10,” in hopes of distracting the patient as the gases take their effect.It is clear that the act of administering inhalational anesthesia is strikingfear and anxiety in the patient. As the countdown continues, the uncertaintywith going under begins to plague the patient’s mindwith fear-ridden thoughts: “What if I’m not fully asleep during the operation? What if I don’t wake up after?” But, amid the turmoil, theeyes will eventually close and the patient will drift into unconsciousness asthe anesthesiologist assumes responsibility over the care of the patient.
This multimedia art piece captures the sentiment offear among patients toward general anesthesia. The thoughts of going under sendshivers down the spines of many people. To some, the thought of undergoinggeneral anesthesia is a more terrifying ordeal than the surgery itself; othersmay so much as cancel their operation. Whileanxiety may be a common experience among patients, it does not come withoutrisks and complications.
As our anxious patient now lies anesthetized in theoperation theater, higher anesthetic doses may be required to maintain anacceptable level of sedation for the procedure to go smoothly. Even after thepatient opens their eyes in the recovery room, a wave of postoperativepsychologic distress may overwhelm them—remnants of their initial fear. Not to mention, greater analgesiause may be needed to subdue the physical pain paralyzing their body as theeffects of the general anesthesia wear off.
Given the negative consequences of patient anxiety, itbegs the question: How do anesthesiologists help anxious patients going intosurgery? The preoperative role of an anesthesiologist becomes increasinglyimportant here. Apart from thoroughly examining the patient and their historyto develop a safe anesthetic plan, anesthesiologists also establish a trustingphysician–patient relationship through apreanesthesia interview. Ina series of questions addressing general anxiety to specific anesthesia-relatedworries, a patient may transition from being anxious to completely confidentbefore operation. In fact, many patients report reduced fear of anesthesia aswell as increased reassurance and satisfaction after preanesthesia interviews—illustrating the power of communication.
In retrospect, perhaps our patient (see ) simply needed reassurance going into theiroperation. Conceivably, having concerns addressed may have been enough for thepatient to go from being anxiety stricken to peacefully counting down as theinhaled gas drifts them into slumber.
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