REGIONAL ANAESTHESIA Effect of preoperative multimedia information on perioperative anxiety in patients undergoing procedures under regional anaesthesia H. A. Jlala 1 , J. L. French 2 , G. L. Foxall 2 , J. G. Hardman 1 * and N. M. Bedforth 2 1 Division of Anaesthesia and Intensive Care, University of Nottingham, Nottingham NG7 2UH, UK. 2 Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham NG7 2UH, UK *Corresponding author. E-mail: j.hardman@nottingham.ac.uk Background. Provision of preoperative information can alleviate patients’ anxiety. However, the ideal method of delivering this information is unknown. Video information has been shown to reduce patients’ anxiety, although little is known regarding the effect of preoperative multi- media information on anxiety in patients undergoing regional anaesthesia. Methods. We randomized 110 patients undergoing upper or lower limb surgery under regional anaesthesia into the study and control groups. The study group watched a short film (created by the authors) depicting the patient’s in-hospital journey including either a spinal anaesthetic or a brachial plexus block. Patients’ anxiety was assessed before and after the film and 1 h before and within 8 h after their operation, using the Spielberger state trait anxiety inventory and a visual analogue scale. Results. There was no difference in state and trait anxiety between the two groups at enrol- ment. Women had higher baseline state and trait anxiety than men (P¼0.02). Patients in the control group experienced an increase in state anxiety immediately before surgery (P ,0.001), and patients in the film group were less anxious before operation than those in the control group (P¼0.04). After operation, there was a decrease in state anxiety from baseline in both groups, but patients in the film group were less anxiousthan the control group (P¼0.005). Conclusions. Preoperative multimedia information reduces the anxiety of patients undergoing surgery under regional anaesthesia. This type of information is easily delivered and can benefit many patients. Br J Anaesth 2010; 104: 369–74 Keywords: anaesthetic techniques, regional; equipment, videos; stress; surgery, preoperative period Accepted for publication: January 4, 2010 Many patients experience substantial anxiety before oper- ation, 1–7 and this is reported to affect 60–80% of surgical patients. 68 Increased anxiety before surgery is associated with pathophysiological responses such as hypertension and dysrrhythmias 9 and may cause patients to refuse planned surgery. 10 Anxiety also increases the requirement of anaesthetic drugs to produce unconsciousness 9 11 and therefore may indirectly increase the risk of awareness. Anxiety may also worsen patients’ perception of pain and increase requirements for postoperative analgesia. 3 12 Anxiety may decrease patients’ overall satisfaction with perioperative care. 13 Reducing preoperative anxiety may improve surgical outcome, shorten hospital stay, and mini- mize lifestyle disruption. 14 Provision of preoperative information can alleviate patients’ anxiety. 15 – 17 The ideal method of delivering this information is unknown. Written information has been used as an effective way for delivering information to patients, 18 19 but not all patients are literate enough to read and understand an information sheet; in addition, patients will retain information to a variable extent. Multimedia information (in the form of a video) has been the subject of randomized controlled studies, and the value of this form of information in decreasing patients’ anxiety before # The Author [2010]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org British Journal of Anaesthesia 104 (3): 369–74 (2010) doi:10.1093/bja/aeq002 Advance Access publication February 1, 2010 by guest on April 15, 2014 http://bja.oxfordjournals.org/ Downloaded from