What can help relieve anxiety before surgery?

It is very normal to feel anxious before having an operation, especially one or two days beforehand, which are often spent in the hospital preparing for the operation. Sometimes people have day surgery, where they go to the hospital or practice, have the procedure and then go home on the same day. But even then it can be hard not to worry about the operation, the possible risks and the anesthetic beforehand. The main cause of anxiety is the feeling of being at the mercy of a situation that is out of your control. Uncertainty about the consequences of the procedure also plays a role.

Severe anxiety can cause unpleasant symptoms and stress. Typical symptoms include a pounding heart, a racing heart (fast pulse), irregular heartbeat, nausea, a nervous stomach, shortness of breath and sleep problems. These anxiety-related symptoms can be particularly worrying for people who have pain due to a heart condition. Anxiety can make pain worse, as well as making it harder to cope with the pain. But the physical signs of anxiety are usually not a sign that a heart condition is getting worse.

Anxiety also becomes a problem if it makes it harder to understand and remember important things you are told, such as advice about how to prepare for the surgery or about recovering afterwards.

The first thing you can do to reduce anxiety is learn to understand how it affects you. Anxiety is a very strong feeling. One of its functions is to protect us from danger. So anxiety may stop you from getting into dangerous situations in the first place. It also prepares your body so you can defend yourself or quickly escape from the danger – a reaction also known as the “fight-or-flight response.” That's why anxiety increases your heart rate, increases your blood pressure and keeps you awake. But if there is no real danger, this response isn't helpful and can have negative consequences.

Over time, most people learn how to manage their own anxiety and handle frightening situations. They develop suitable strategies to cope with what is causing the anxiety. But going into the hospital and having an operation is often a completely new situation. Here they often need emotional and practical support from friends and family too.

People might cope with pre-surgery anxiety in very different ways: Some try to prevent anxiety or stress by getting information early on and talking with other people about their concerns. Others distract themselves by reading, or use exercise or relaxation techniques like slow and deep breathing. Several studies have suggested that listening to music before surgery can relieve anxiety. Music can help you relax and distract you. Different people will find different types of music helpful, depending on their personal taste in music.

There are some things that all hospitals ought to offer: For example, that the staff understand the needs of the patients, waiting times are kept as short as possible, and the hospital stay is made as pleasant as possible. Caregivers are important to this process because they are close to the people having the surgery.

There will be a preliminary consultation with an anesthesiologist a day or two before you are given the anesthetic for the surgery. Among other things, the use of the anesthetic will be explained to you. There is also an opportunity to talk about your fears and previous experiences with other types of anesthetics. The anesthesiologist can then take that into account when preparing the anesthetic. You will also be informed about the procedure itself. That is done by the surgeons.

Most hospitals provide contact with counselors, social workers or volunteers who offer support and assistance. The most suitable type of professional support will depend on what is causing the anxiety. For example, someone who is afraid of having an anesthetic will need a different type of support than someone who is mostly anxious about being in a hospital. Psychological support may also be a suitable option. Techniques taken from cognitive behavioral therapy can help people cope with anxiety.

Relaxation techniques such as breathing exercises, meditation or muscle relaxation can be helpful. These techniques can be learned in classes or with the help of pre-recorded audio training courses.

Studies show that VR (virtual reality) headsets can help reduce anxiety. You put on the glasses and are instantly transported to another world – for example, an underwater location or an idyllic natural landscape. This is meant to help you relax or simply take your mind off things. VR headsets can also be used to provide information about the procedure. These kinds of headsets. are already in use in some hospitals in Germany.

Massages, acupuncture, homeopathy, aromatherapy or hypnosis are sometimes offered before surgery too. But they haven't been scientifically proven to help relieve anxiety before surgery.

People who are already in hospital the night before an operation are usually given medicine to help them sleep or a sedative to reduce anxiety. These benzodiazepines lower anxiety, help you to relax, and make you sleepy at the same time. But they can also have side effects. There is evidence that suggests they increase the risk of confusion (delirium) following the procedure. They might also make you feel drowsy or nauseous. For this reason, doctors decide on whether benzodiazepines are an option on a case-by-case basis. They are particularly cautious when it comes to older people.

Studies show that melatonin can relieve anxiety before surgery. It seems to have an effectiveness similar to benzodiazepines. Melatonin is actually used relatively rarely before surgery though, because there is more and better research on the effectiveness of benzodiazepines for this purpose. But melatonin may be a good alternative for people who aren't able to use benzodiazepines,

Many people who smoke tend to smoke even more when they’re feeling anxious. Even if that calms their nerves in the short term, smoking is associated with a higher risk of complications after surgery – particularly complications related to the wound-healing process. Quitting smoking a few weeks before surgery can reduce the risk of complications.