국소 마취하 경미한 수부 수술 환자의 수술 전 불안에 대한 단면적 연구 = Preoperative Anxiety in Minor Hand Surgery under Local Anesthesia: A Cross-Sectional Analysis

다국어 초록 (Multilingual Abstract)

Abstract

Background: Preoperative anxiety can affect analgesic needs, cooperation, and the overall experience during awake local-anesthesia hand surgery. We aimed to quantify immediate preoperative anxiety, identify independent predictors, and characterize patient-reported sources, timing, and relief factors.

Methods: This cross-sectional observational study analyzed data from 34 adults undergoing elective minor hand surgery under local anesthesia. Preoperative state anxiety was measured immediately before surgery using the State–Trait Anxiety Inventory Form X (STAI-X). A structured questionnaire adapted from prior research, administered before discharge, was used to retrospectively assess patient-reported sources of anxiety, its peak timing, and factors related to relief. After univariable screening of potential predictors, a multivariable linear regression model was fitted to identify independent predictors of the STAI-X score.

Results: The final analytic cohort comprised 34 patients with a mean preoperative STAI-X score of 38.1 ± 11.2. Multivariable analysis revealed that female sex was the only significant independent predictor of higher preoperative anxiety (β = 11.9; 95% CI, 1.4 to 22.4; P = 0.028), whereas age, alcohol consumption, and surgical history were not significant. Patient-reported perceptions showed that the most frequent source of anxiety was 'Postoperative pain' (55.9%), and that anxiety most often peaked 'While waiting on the day of surgery' (47.1%). For relief, patients most commonly cited 'Trust in the medical staff' preoperatively (67.6%), while postoperatively, the most frequent relieving factor was 'The fact that the surgery was over' (47.1%), followed by 'The surgeon’s explanation' (29.4%).

Conclusions: This exploratory study suggests that a significant level of anxiety exists in patients undergoing even minor hand surgery under local anesthesia. While our findings highlight the surgeon’s crucial and modifiable role in alleviating patient distress, female sex emerged as a potential predictor. Trust and communication were identified as the most valued components of the patient experience, emphasizing the surgeon’s function as a direct therapeutic agent in the unique setting of conscious surgery.

Keywords: Preoperative Anxiety; Hand Surgery; Local Anesthesia; State-Trait Anxiety Inventory; Physician-Patient Relations; Patient experience

목차 (Table of Contents)

• Abstract
• Table of Contents
• List of Tables
• List of Figures
• Supplementary Material
• 1. Introduction 17
• 2. Materials and Methods 18
• 2.1 Study Design and Participants 18
• 2.2 Procedures and Data Collection 19
• 2.3 Variables 19
• 2.4 Outcome Measures 19
• 2.5 Statistical Analysis 20
• 3. Results 21
• 3.1. Cohort Selection 21
• 3.2. Baseline Characteristics 21
• 3.3. Univariable Analysis of Factors Associated with Preoperative Anxiety 21
• 3.4. Multivariable Analysis of Factors Associated with Preoperative Anxiety 22
• 3.5. Analysis of Patient-Reported Perioperative Experience 22
• 4. Discussion 22
• 5. Conclusions 26
• References 28
• Abstract in Korean 32