Comparing the Efficacy of Midazolam Alone, With a Stress Ball, or With Hand-Holding and Conversation in Reducing Preoperative Anxiety in Elective Laparoscopic Cholecystectomy: A Randomised Controlled Trial.

INTRODUCTION

Preoperative anxiety exists frequently and exerts an impact on overall surgical outcomes as well as the management of anaesthesia. The aim of this study was to evaluate the effectiveness of hand-holding and conversation with a stress ball, along with a control group of midazolam, in reducing preoperative anxiety.

METHODS

We randomly divided 150 patients into three groups of 50 patients each: group A (hand-holding and conversation with midazolam), group B (stress ball use with midazolam), and group C (midazolam only). After taking informed and written consent, we recorded the Amsterdam Preoperative Anxiety and Information Scale (APAIS) score and haemodynamic parameters before and after intervention. We recorded the Visual Analogue Scale (VAS) score and patient satisfaction score in the postoperative period.

RESULTS

The APAIS anxiety score was lowest in group A (6.2 ± 1.2) compared to group B (7.3 ± 1.3) and highest in group C (8.0 ± 1.1), respectively (P < 0.001). The minimum alveolar concentration (MAC) values for time points 15 and 30 minutes were 1.01 ± 0.06 and 1.03 ± 0.10 in group A, compared to 1.06 ± 0.10 and 1.07 ± 0.11 for group B and 1.07 ± 0.10 and 1.07 ± 0.09 for group C, respectively (P = 0.002 for 15 minutes). The patient satisfaction scores immediately after surgery were 4.2 ± 1.1 for group A, 3.7 ± 1.1 for group B, and 3.6 ± 0.9 for group C, respectively (P = 0.015).

CONCLUSION

Hand-holding and conversation with midazolam seems to be more effective in reducing preoperative anxiety compared to stress ball use in combination with midazolam and midazolam alone, and the hand-holding group had lower intraoperative anaesthetic requirement and higher patient satisfaction.