Journal of anesthesia and translational medicine · 2026
Association of preoperative state anxiety and early postoperative recovery in living kidney donors undergoing nephrectomy: A prospective observational study.
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Chohan Maham Javed, Bukhari Syed Jawad Ali, Waheed Zargham, Javaid Munawal, Ahmad Zaeema, Sarfraz Sara, Khalid Amnah
Аннотация
BACKGROUND: Preoperative anxiety may influence perioperative physiological responses, early postoperative recovery, postoperative pain, and patient satisfaction in living kidney donors. This study evaluated the association between preoperative state anxiety and early postoperative recovery outcomes in adults undergoing elective living kidney nephrectomy.
METHODS: In this prospective observational study, 100 consecutive living kidney donors undergoing elective donor nephrectomy at Bahria International (SAFARI) Hospital, Rawalpindi, Pakistan, from January 2024 to December 2025, were enrolled. The primary endpoint was post-anaesthesia care unit (PACU) stay duration. Secondary endpoints included extubation time, time to achieve Modified Aldrete Score ≥9, postoperative pain, analgesic consumption, patient satisfaction, postoperative nausea and vomiting (PONV), and postoperative length of stay. Preoperative state anxiety was assessed on the day before surgery using the State-Trait Anxiety Inventory-State Scale (STAI-S) in English and Urdu. Skewed outcomes were summarized as median and interquartile range [IQR], while the Kruskal-Wallis test was used for anxiety group comparison. STAI-S was approximately normally distributed and is reported as mean and standard deviation. Multiple linear regression was performed to identify predictors of PACU stay adjusted for prespecified confounders.
RESULTS: The mean STAI-S score was 43.14 ± 11.97, with n = 44 (44%) donors categorized as low, n = 33 (33%) as moderate, and n = 23 (23%) as high anxiety. Higher anxiety was associated with longer extubation time, delayed Aldrete recovery, longer PACU stay, greater pain at 1 h and 6 h, lower patient satisfaction, and longer hospital stay. In multivariable analysis, higher preoperative anxiety scores were associated with longer PACU stay duration (β = 0.768, p < 0.001), explaining 55.8% of the variance (R² = 0.570).
CONCLUSIONS: Higher preoperative state anxiety scores were associated with lower early postoperative recovery scores, greater early postoperative pain, longer hospital stay, and lower patient satisfaction among living kidney donors.
METHODS: In this prospective observational study, 100 consecutive living kidney donors undergoing elective donor nephrectomy at Bahria International (SAFARI) Hospital, Rawalpindi, Pakistan, from January 2024 to December 2025, were enrolled. The primary endpoint was post-anaesthesia care unit (PACU) stay duration. Secondary endpoints included extubation time, time to achieve Modified Aldrete Score ≥9, postoperative pain, analgesic consumption, patient satisfaction, postoperative nausea and vomiting (PONV), and postoperative length of stay. Preoperative state anxiety was assessed on the day before surgery using the State-Trait Anxiety Inventory-State Scale (STAI-S) in English and Urdu. Skewed outcomes were summarized as median and interquartile range [IQR], while the Kruskal-Wallis test was used for anxiety group comparison. STAI-S was approximately normally distributed and is reported as mean and standard deviation. Multiple linear regression was performed to identify predictors of PACU stay adjusted for prespecified confounders.
RESULTS: The mean STAI-S score was 43.14 ± 11.97, with n = 44 (44%) donors categorized as low, n = 33 (33%) as moderate, and n = 23 (23%) as high anxiety. Higher anxiety was associated with longer extubation time, delayed Aldrete recovery, longer PACU stay, greater pain at 1 h and 6 h, lower patient satisfaction, and longer hospital stay. In multivariable analysis, higher preoperative anxiety scores were associated with longer PACU stay duration (β = 0.768, p < 0.001), explaining 55.8% of the variance (R² = 0.570).
CONCLUSIONS: Higher preoperative state anxiety scores were associated with lower early postoperative recovery scores, greater early postoperative pain, longer hospital stay, and lower patient satisfaction among living kidney donors.