February 21, 2023

Afraid of Surgery? Overcoming Anesthesia Fear

Dr. Kaveh explains the reasons for fear and anxiety before surgery. He explains how anxiety, fear of pain, and PTSD are large contributors

Undergoing surgery can be a daunting experience for many people, and one of the biggest sources of anxiety is the fear of anesthesia. We'll explore why people are afraid of anesthesia, the 5 factors that contribute to anxiety before surgery, and ways to overcome that fear.

Is It Normal to Be Scared of Anesthesia?

It is completely normal to feel anxious or scared before surgery. Up to 40% of people feel some level of anxiety before surgery and anesthesia.

What Is the Fear of Anesthesia Called?

The fear of anesthesia is referred to as anesthesiophobia. It's a type of anxiety disorder that is characterized by an intense fear or phobia of receiving anesthesia.

Why Are People Afraid of Anesthesia?

There are several factors that contribute to the fear of anesthesia. Here are the 5 main factors that contribute to anxiety before surgery:

1) Lack of Control in the Surgery and Anesthesia

Our brains and bodies crave control. In fact, our brain will throw itself into a pathological loop of anxiety sometimes just to try to maintain control. However, this imbalance of control craving can be serious before surgery and anesthesia. Learning to accept control over what we can control is thus very important before surgery. Some common techniques include rituals, breathing techniques, biofeedback, and emphasizing the choice we have in chosing to have surgery.

2) Lack of Certainty in the Surgery and Procedure

Our brains flounder when we are uncertain. In fact, they will also spin out of control, at the expense of hurting ourselves, when we are uncertain about outcomes. This is why emphasizing the certainty in our decision to have surgery is so powerful. As the saying goes, knowledge is power. Therefore, the more knowledge we have about the surgery, and how that surgery will help us, we can feel more certain about going under anesthesia for surgery. I work with my patients to gain confidence in their heart of hearts that they want this surgery, and that they are certain that the surgeon will do their very best to help them with their surgery. They also need to be certain that their anesthesiologist is caring and compassionate throughout the process.

3) Lack of Confidence that Surgery is the Right Choice

Confidence is a powerful tool to overcome fear and anxiety, especially in the operating room. When we are not confident in our future outcomes, we begin to go into inwardly focused perseveration and rumination about possible bad outcomes. This is why preparing for surgery is so important. Strategies like exposure therapy and having a pain plan can be powerful to give us the confidence that we are ready for surgery. This confidence can directly counteract fears and doubts about surgery. Overcoming those fears and doubts can help us overcome the fears and anxieties before going surgery and anesthesia.

4) Lack of Trust in the Care Team

Trust is one of the most powerful tools to prevent traumatic experiences from turning into PTSD. Because PTSD can be so serious after surgery, what we call medical PTSD, it is paramount that we appreciate the importance of trust in our care team. For example, if a patient has a little bit of anesthesia awareness under anesthesia, like being awake a little bit, that traumatic experience can lead to serious PTSD. However, the more trust we have in our surgeon, anesthesiologist, and other care team professionals, the less likely that traumatic experience is to develop into PTSD.

5) Lack of Curiosity in What's Happening to the Body

Curiosity is one of our most powerful tools to counteract fear and anxiety. This is because curiosity, in particular when it is born from inspiration, as opposed to deprivation, can help us expand our consciousness to things beyond ourselves. The outward focus of curiosity is inherently an antidote to the inward of fear and anxiety. Curiosity can not only help us better interact with our anesthesiologist and surgeon, but can also help build confidence in our decision to have surgery.

Can You Go Under Anesthesia if You Have Anxiety?

Yes, it is possible to undergo anesthesia if you have anxiety. Discussing your anxiety with your anesthesiologist and care team is important to find the right techniques and medications to manage your anxiety. According to a study published in the Journal of Anesthesia, techniques such as cognitive-behavioral therapy and medication can be effective in managing preoperative anxiety.

What does it feel like to go under Anesthesia?

The experience of going under anesthesia can vary depending on the type of anesthesia used. However, most people describe the sensation as similar to falling asleep. The anesthesiologist will monitor your vital signs and adjust the anesthesia as needed to ensure that you remain safe and comfortable.

Why It's Okay to Be Scared Before Surgery

Feeling scared before surgery is completely normal and understandable. It is important to acknowledge and manage your fear and anxiety to ensure that you are mentally prepared for the procedure. According to the American Society of Anesthesiologists, managing fear and anxiety before surgery can lead to a better recovery and less postoperative pain. It is important to be honest with yourself and your care team about your feelings and concerns before the procedure.

Why You Shouldn't Be Afraid of General Anesthesia

General anesthesia is a safe and effective way to ensure that you are comfortable and pain-free during surgery. The American Society of Anesthesiologists reports that the risks of anesthesia are low, and the benefits far outweigh the risks.

Safety and Effectiveness of General Anesthesia

General anesthesia is carefully monitored and tailored to each individual patient to ensure safety and effectiveness. Modern anesthetics are carefully designed to minimize side effects, and the care team will continuously monitor your vital signs throughout the procedure.

Advancements in Anesthesia Technology

Advancements in anesthesia technology have made it even safer and more effective than ever before. For example, the use of Bispectral Index (BIS) monitoring can help anesthesiologists more accurately monitor the level of consciousness of the patient during the procedure.

What Should You Not Do Before Anesthesia?

There are certain things that you should avoid before undergoing anesthesia to ensure safety and effectiveness. Here are some guidelines to follow:

Alcohol Before and After Surgery

Alcohol can have serious side effects before and after anesthesia. You should hold off on drinking alcohol for 4-6 weeks before surgery. Similarly, you should wait for your healing to complete before starting to drink alcohol again.

Eating and Drinking Restrictions Before Surgery

It is important to follow your doctor's instructions regarding eating and drinking restrictions before surgery. Fasting before surgery helps to prevent complications such as aspiration.

Avoiding Certain Medications Before Surgery

Certain medications, such as blood thinners, should be avoided before surgery to prevent excessive bleeding. It is important to discuss all medications that you are taking with your care team before the procedure.

Hygiene and Dressing Guidelines Before Surgery

Your care team may provide specific hygiene and dressing guidelines to follow before surgery. This may include bathing with an antimicrobial soap to reduce the risk of infection.

What Happens If You Don't Sleep Before Anesthesia?

Getting adequate sleep before surgery is important for both physical and mental health. Lack of sleep before anesthesia can lead to increased anxiety, decreased immune function, and other complications. According to a study published in the Journal of Clinical Sleep Medicine, sleep deprivation before surgery is associated with increased postoperative pain and longer hospital stays.

How Long Does It Usually Take to Wake Up from Anesthesia?

The length of time it takes to wake up from anesthesia can vary depending on the type of anesthesia used and the individual patient. It typically takes a few minutes to a few hours to fully wake up from anesthesia. Your care team will monitor your vital signs and adjust the anesthesia as needed to ensure that you wake up safely and comfortably.

References:

  1. American Society of Anesthesiologists. (2019). Preparing for Anesthesia. Retrieved from https://www.asahq.org/whensecondscount/preparing-for-surgery/preparing-for-anesthesia
  2. Pavlin, J. D., et al. (2005). Management of preoperative anxiety in surgical patients: an evidence-based review. Anesthesia & Analgesia, 101(3), 781-788.
  3. American Society of Anesthesiologists. (2020). Anesthesia and You. Retrieved from https://www.asahq.org/for-the-public-and-media/anesthesia-and-you
  1. American Society of Anesthesiologists. (2016). Anesthesia safety. Retrieved from https://www.asahq.org/whensecondscount/patientsafety/anesthesia-safety/
  2. Leslie, K., & Short, T. G. (2011). Monitoring consciousness during anesthesia: the pendulum swings back. Journal of Clinical Monitoring and Computing, 25(3), 165-168.
  3. Li, Y., et al. (2018). Association between preoperative sleep and postoperative pain outcomes in elective total joint arthroplasty patients. Journal of Clinical Sleep Medicine, 14(12), 2007-2016.
  4. Cakmakkaya, O. S., et al. (2010). Anxiolytic pretreatment for decreasing preoperative anxiety: a systematic review and meta-analysis. Anesthesia & Analgesia, 111(6), 1394-1403.
  5. Apfelbaum, J. L., et al. (2019). Practice guidelines for moderate procedural sedation and analgesia 2018: a report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. Anesthesiology, 130(6), 1261-1277.
  6. Gupta, D., & Jindal, P. (2016). Management of perioperative anxiety in adults: A review. Journal of Anaesthesiology Clinical Pharmacology, 32(2), 146-150.
  7. Kain, Z. N., et al. (2014). Preoperative anxiety and emergence delirium and postoperative maladaptive behaviors. Anesthesia & Analgesia, 119(3), 694-705.

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