[Significance of smoking and cigarette abstinence regarding anxiety in gynecologic patients in a perioperative period]

Abstract

Smoking cigarettes adds to risk of anesthesia and surgery, and also may influence anxiety. However, cigarette abstinence may increase preoperative stress. The study aimed at exploring the relationship between smoking and anxiety in gynaecologic patients in the perioperative period, and also finding out whether the abstinence and history of unsuccessful cessation attempts are connected with an anxiety pattern at that time. A relationship between anxiety and postoperative pain should be also examined. In 24 smokers and 24 non-smokers subjected to hysterectomy the anxiety level was examined by means of both Spielberger's state and trait inventory (STAI) and visual-analog scale (VAS) before and following surgery; maximal pain on the first postoperative day was also assessed by VAS scale. Smokers additionally completed an inventory of smoking behavior. Pre- and postoperatively the anxiety level was comparable in both groups. Before surgery but not after it, state anxiety overtopped the trait in both smokers and non-smokers. Postoperatively state anxiety was connected with the trait and morphine consumption. Cigarette abstinence before surgery did not influence anxiety; however, state anxiety correlated with the length of abstinence. In smokers with the history of smoking cessation attempts, preoperative state anxiety was higher. Between smokers and non-smokers no differences in postoperative pain and no significant relationship with the anxiety could be found, Conclusions: 1) Perioperative anxiety is comparable in both smoking and non-smoking gynaecologic patients. 2) Cigarette abstinence before surgery is not connected with any significant anxiety differences. Smokers with the history of unsuccessful cessation attempts preoperatively present with higher state anxiety.