This is a prospective Turkish study that looked at factors affecting the postoperative pain response after septoplasty, a common ENT surgical procedure. Sixty patients were included in the study who underwent septoplasty. The authors looked at the influence of demographics and preoperative anxiety (measured using the Spielberger State-Trait Anxiety Index, a validated scoring system) on postoperative pain [measured using a Visual Analogue Scale (VAS) preoperatively and at intervals up to 24 hours postoperatively]. While the authors found no correlation between patients’ age and educational status and their postoperative pain levels, they did find a significant relationship between patients’ preoperative anxiety and their postoperative pain levels in the immediate and late periods. They also found that women were more likely to complain of more severe postoperative pain than men, in common with previous literature.

The authors hypothesise that the physiological anxiety stress response can have an adverse effect on postoperative healing.

This study is subject to some limitations, such as a small series of patients, presence of confounding factors, and lack of control group. However, the important message that this study does carry is that it is important to take a holistic view with our patients, and to recognise preoperative anxiety regarding their surgery and manage this as necessary, as well as including anxiety-reducing strategies in the postoperative period alongside standard analgesia.

Preoperative anxiety and postoperative pain in patients undergoing septoplasty.
Ocalan R, Akin C, Disli ZK, Kilinc T, Ozlugedik S.
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Sunil Sharma

Alder Hey Children's Hospital, UK.

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