Assessment of Patients' Knowledge and Anxiety Regarding General Anesthesia Before Elective Surgery

Background: General anesthesia is an essential component of modern surgical care; however, patients may have limited knowledge regarding anesthesia and the role of anesthesiologists, which may contribute to uncertainty and preoperative anxiety. Assessing both knowledge and anxiety may help improve the quality of preoperative anesthetic care. Objective: To assess patients’ knowledge regarding general anesthesia and their level of preoperative anxiety before elective surgery, and to determine the association between knowledge level and preoperative anxiety. Methods: A hospital-based cross-sectional study was conducted among 50 patients undergoing elective surgery under general anesthesia at Imam Al-Hussein Hospital in the Holy Karbala Governorate, Iraq. Data were collected on April 5, 2025. Patients’ knowledge was assessed using a structured knowledge questionnaire and categorized as poor, moderate, or good. Preoperative anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Descriptive and inferential statistical analyses were performed using SPSS, with a p-value <0.05 considered statistically significant. Results: Of the 50 participants, 25 (50.0%) were male and 25 (50.0%) were female. Moderate knowledge was the most common level (52.0%), followed by poor knowledge (34.0%) and good knowledge (14.0%). The mean APAIS anxiety score was 11.96 ± 2.56, and 35 participants (70.0%) had an APAIS anxiety score >10. Mean anxiety scores were highest among patients with poor knowledge (13.88 ± 2.00), followed by moderate knowledge (11.31 ± 2.20) and good knowledge (9.71 ± 2.06). A statistically significant difference in anxiety scores was observed across knowledge groups (F = 12.176, p < 0.001). Knowledge level was also significantly associated with high preoperative anxiety (χ² = 8.051, p = 0.018). A significant negative correlation was observed between knowledge level and APAIS anxiety score (rₛ = −0.591, p < 0.001). Sex and type of operation were not significantly associated with anxiety. Conclusion: Limited knowledge regarding general anesthesia and high preoperative anxiety were common among patients undergoing elective surgery. Higher knowledge levels were significantly associated with lower preoperative anxiety. These findings emphasize the importance of structured, patient-centered preoperative anesthesia education and individualized communication to improve patients’ understanding and potentially address anxiety before surgery.