Abstract
Purpose: The purpose of this study was to evaluate the changes in the amount of pre- and post- operative stress and the associated reduction in anxiety in patients undergoing elective orthopedic surgery. Methods: Thirty-nine patients undergoing elective orthopedic surgery for benign diseases are herein studied. Anxiety was assessed using the State-Trait Anxiety Inventory (STAI Y-1), both before and after surgery. Perioperative stress was evaluated using amylase in saliva (AMY) at the time of the patient entered the operating room and thereafter on the first post-operative day. Patient satisfaction was evaluated postoperatively using a standardized questionnaire. Results: 1) The postoperative STAI Y-1 score decreased from 45.3 (preoperative) to 43.6. 2) Although, the mean postoperative amylase level was slightly increased from 55.7 KU/L to 62.9 KU/L, 61.5% of the patients showed no stress level at any time or a decrease in the postoperative AMY level. 3) Surgery of the cervical vertebra, the shoulder the clavicle, the upper extremities and the ankle tended to show a higher AMY score postoperatively. 4) According to the results of a questionnaire, the chief causes of the postoperative stress were the wound pain, thirst and lumbago. Conclusion: Both the strategies to reduce preoperative anxiety and the careful management of postoperative wound pain were found to be important factors for reducing perioperative stress.
