The Influence of Preoperative Situational Anxiety on Postoperative Pain Sensitivity: Implications for Anesthetic Technique Selection in Laparoscopic Abdominal Surgery

Abstract Introduction: This pilot prospective study aimed to improve the effectiveness of perioperative analgesia in patients undergoing laparoscopic abdominal surgery (LAS) through an individualized choice of anesthetic technique based on preoperative situational anxiety (SA) and pain threshold (PT). Materials and methods The study included 120 patients aged 22–82 years (25 men [20.8%] and 95 women [79.2%]) who underwent laparoscopic surgery for abdominal conditions of various localizations. Postoperative hyperalgesia (PH) was assessed using measures of peripheral and central pain sensitization, including changes in PT and the extent of the pain perception zone (PPZ). Preoperative psychometric assessment was combined with quantitative sensory testing using algometry. Results In patients with low preoperative anxiety (SA ≤ 44 points), both anesthesia methods (MGA and CA) were reliable in preventing signs of PH. However, highly anxious patients (SA ≥ 45) required combined spinal anesthesia, since the isolated use of multicomponent general anesthesia in laparoscopic abdominal surgical interventions was unable to prevent manifestations of postoperative hyperalgesia. Conclusions The findings support an individualized approach to anesthetic selection in patients undergoing LAS. Both the combined anesthesia (CA) and the multicomponent general anesthesia (MGA) may be appropriate for patients with low preoperative SA, whereas CA may be preferable in patients with high SA (≥ 45 points on the Spielberger–Hanin scale). These findings should be interpreted in light of the pilot study design and require confirmation in larger studies. Citation: Posternak H.I., Melnyk O.P., Moiseienko A.I., Midlovets K.K. Іnfluence of Patients' Psychoemotional Profile on the Choice of Anesthetic Technique for Laparoscopic Abdominal Surgery. Bogomolets National Medical University 2026;20.