Anxiety constitutes one of the most important psychological factors influencing body reaction to surgical injury; in gynecological patients anxiety ratings appear especially high. Cigarette smoking belongs to essential risk factors in the perioperative period and may result in increased levels of anxiety. A pilot study has been carried out with the aim of evaluating the impact of smoking habit on the perioperative anxiety level and postoperative pain in women undergoing gynecological surgical procedures. In 9 smokers and 10 non-smokers, anxiety was assessed by means of the State Anxiety Score of the Spielberger State-Trait Anxiety Inventory (STAI) and the visual analog scale (VAS), preoperatively and on the second day after surgery. Additionally, intraoperative and postoperative opioid analgesic uses were analyzed and on the second day after surgery patients rated their recall of postoperative pain with the use of the VAS. Postoperative State anxiety was lower than that reported preoperatively only in non-smokers (median: 53.0-40.0, p=0.02, Wilcoxon p=0.02). Smoking did not significantly influence intra- and postoperative opioid analgesic requirements and postoperative pain.
Conclusions: This study suggests that in female smokers subjected to gynaecological surgery cigarette smoking may contribute to altered anxiety kinetics in the perioperative period.