Source #2 Bibliography:

Bansal, Teena and Akanksha Joon. “Preoperative Anxiety – An important but Neglected Issue: A Narrative Review.” Indian Anesthetists’ Forum, vol.17, no. 2, Jul-Dec2016, pp. 37-42.EBSCOhost, doi:10.4103/0973-0311.195955

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This article introduces preoperative anxiety by explaining what exactly it is and the complications that can arise from it such as “difficult venous access due to peripheral vasoconstriction, autonomic fluctuations, delayed jaw relaxation and coughing during induction of anesthesia, and increased anesthetic requirement” (Bansal and Joon 37). It then goes into how to measure preoperative anxiety by indirect measurement of sympathetic-adrenal activity such as heart rate and blood pressure or direct measurement of sympathetic-adrenal activity such as plasma cortisol, urinary catecholamine excretion, and plasma catecholamine. Subjective methods include the HAD, STAI, VAS-A, APAIS, MAACL, and LAAS. The next sections of the article go into each of these tests, explaining what questions they consist of and the benefits or limitations of each. The article then goes on explain a few studies that have been conducted on preoperative anxiety, most of which are concerned with which methods is the most effective for measurement. It ends with a section on how to treat and prevent preoperative anxiety, explaining that mainly “information about surgery reduces anxiety in the preoperative period” (Bansal and Joon 41) and that the most beneficial outcomes have been reported when patients are shown an informative video. I not only want my research to answer how preoperative anxiety is treated but also why it is important to treat. The article explains that preoperative anxiety occurs 11 to 88 percent of the time and the various factors influencing anxiety include age, gender, the extent and type of surgery, previous hospital experiences, susceptibility to and ability to cope with stressful experiences, and preoperative information. (Bansal and Joon 37). In addition to the complications it can create during surgery, preoperative anxiety has been correlated with increased pain, nausea, and vomiting in the postoperative period, a prolonged recovery, and an increased risk for infection. (Bansal and Joon 37). While sedative premedication is routinely administered to reduce preoperative anxiety, the sedatives have their own side effects which can be minimized by using nonpharmacological techniques. (Bansal and Joon 41). For these reasons, it is important that the anxiety be treated in the preoperative period. The article notes that the most beneficial way to do this is through the use a documentary video which is proven to be a “more effective technique than a brochure or a personal interview alone for conveying information to patients undergoing surgery” (Bansal and Joon 41). This article is excerpted from the Indian Anesthetists’ Forum which provides credible information covering anesthesiology, critical care, and pain management. The articles are selected for publication based on a double-blind review process and emphasis is on quality. Adding to this article’s reliability, it was found on Galileo, a website known to provide credible sources to students. The information in this article has allowed me to better understand what exactly preoperative anxiety is and why it is important to prevent it. It provides valuable information on the many methods for measuring preoperative anxiety and the most effective ways to treat it based on studies conducted in the past. Overall, this article answers many of the questions I have regarding my topic and has guided my research.