Perioperative anxiety: psychobiology and effects in postoperative recovery

Anxiety is a frequent symptom during the perioperative period. This symptom has been found to correlate with high postoperative pain, increased analgesic and anaesthetic consumption, and prolonged hospital stay. In addition, anxiety may influence adversely the anaesthetic induction and patient recovery, as well as decrease patient satisfaction with perioperative experience. However, this overview has the objective of reviewing knowledge of perioperative anxiety - psychobiology, clinical repercussion and the effect of interventions used to control perioperative anxiety. Some historic aspects, the psychobiological mechanism, clinical repercussion of perioperative anxiety, and the effect of interventions used to control perioperative anxiety have been reviewed, as well as the role of perioperative anxiety upon anaesthesia, pain and patient recovery. Also, the effect of the approach used to control perioperative anxiety is presented. From this overview, it is evident that anxiety is of fundamental importance in perioperative morbidity. However, many questions have not been answered and new studies are needed to determine the effect of interventions used to control perioperative anxiety on postoperative outcomes.