Prevention of perioperative anxiety: Interest of audiovisual distraction.

Introduction: Audiovisual distraction (AVD) is one of the non-pharmacological means of anxiety prevention. However, few studies have evaluated its perioperative effect in adults.

Aim: To evaluate the contribution of audio-visual distraction in the prevention of perioperative anxiety in adult patients proposed for surgery under spinal anesthesia.

Methods: This was a prospective randomized controlled study lasting three months from July 1, 2021. We included ASA I to III over 18 years patients, proposed for visceral or orthopedic surgery under spinal anesthesia. We didn't include patients operated in lateral or prone positions or with a history of anxiety disorders or communication difficulties. 90 patients were randomized into two groups: a control group T and a group A who had an AVD throughout the operation. The primary outcome was anxiety as assessed by the visual analogue scale (VAS).

Results: Demographic characteristics, Amsterdam preoperative anxiety and information scale (APAIS) and pain levels were comparable between the two groups. During the surgery, 22 (48.9 %) patients in group T versus 3 (6.7 %) in group A required Midazolam (p < 0.001). Anxiety assessed by VAS at the end of the act was lower in group A (p < 0.001). The pain levels also were lower in patients who received AVD (p = 0.004). A patient satisfaction score (Iowa Satisfaction with Anesthesia Scale French version) ≥ 5.4 was more frequently observed in group A (p < 0.001).

Conclusion: AVD reduced perioperative anxiety and decreased the use of midazolam during surgery performed under spinal anesthesia.