Effectiveness of Preoperative Multimedia Video-based Education on Anxiety and Haemodynamic Stability of Oncosurgery Patients Undergoing Spinal Anaesthesia- A Randomised Controlled Trial

Abstract

Introduction: Most of the patients posted for surgery experience anxiety and this is more pronounced in cancer patients posted for oncological surgery. The majority of it arises from apprehension stemming from a lack of understanding of anaesthetic procedures and surgery. Aim: To assess the effectiveness of multimedia-based educational video shown preoperatively to cancer patients posted for surgery in alleviating anxiety associated with spinal anaesthesia/sub arachnoid block. Materials and Methods: This was a randomised controlled trial conducted on a total of 200 patients posted for oncological procedure in Department of Anaesthesiology and Pain relief, Kidwai Memorial Institute of Oncology, Bengaluru, India. the total subjects included were randomised into two groups: Video group, where a short educational video depicting procedure of spinal anaesthesia was shown preoperatively to the patients and non video group (control group) where no video was shown. Anxiety using Visual Analogue Scale (VAS) and haemodynamic parameters like Heart Rate (HR), Mean Arterial Pressure (MAP), Systolic blood Pressure (SBP), Diastolic blood pressure (DBP) were assessed pre and post intervention in both groups. Categorical data were compared using Chi-square test. Student’s unpaired t-test was used for inter-group comparison. The p-value <0.05 was considered statistically significant. Results: Out of total 200 patients (93 males and 107 females; 18-60 years of age) enrolled in the study, 100 patients were categorised in video group (41.53±11.60 years) and remaining 100 were included in non video group (42.92±11.63 years). There was no statistically significant difference in the mean anxiety score and haemodynamic parameters at the baseline for both the groups. Post intervention, the video group showed a greater reduction in anxiety than the control group (intra-group reduction: 1.84±1.20 vs 1.42±1.18), and the difference was statistically significant (p-value=0.013). Mean HR was significantly higher in the control group (84.66±13.22, 80.46±13.11 and 79.44±14.05 at 5, 10 and 15 min, respectively) when compared with the video group (81.75±11.49, 77.35±12.59 and 74.82±13.05 at 5, 10 and 15 min, respectively). Similarly, SBP, DBP and MAP were noted significantly higher in the control group compared to the video group (p-value <0.001). Conclusion: Multimedia-based educational video depicting technique of spinal anaesthesia/sub arachnoid block significantly reduces anxiety and associated haemodynamic variations. Showing short video clip about spinal anaesthesia technique is an easy way for transfer of information about anaesthesia for patients and allows time for patients to reflect on this preoperatively and thereby reduces their anxiety.

Keywords

• anaesthesia information
• anxiolysis
• cancer surgery
• sub arachnoid block