Perioperative mental status assessment of patients undergoing general surgical procedures

Prem Kumar A., Raksha Nadig, Shashikala V., Vikram Arunachalam


Background: The past few decades have seen an enormous increase in the number of patients undergoing curative and palliative surgical procedures. The objective of the present study was to assess the mental status in a patient undergoing a general surgical procedure perioperatively.

Methods: 105 patients admitted in a surgical ward, posted to undergo an elective surgical procedure were evaluated to assess their psychological status. Each patient was subjected to a Brief Psychiatric Rating Scale questionnaire twice, once preoperatively and postoperatively. Both sessions were conducted in a calm environment and the patient was administered adequate analgesia to eliminate bias due to pain. The preoperative and postoperative scores were calculated and compared.

Results: BPRS is a psychiatric rating scale used in various psychiatric conditions. Using this scale, we were able to detect the presence of a baseline low mood in a patient undergoing a surgical procedure. The average score preoperatively was 35.84 and postoperatively was 32.68. These scores were higher in patients undergoing surgeries for malignant conditions and also in those with co-morbid conditions like diabetes mellitus. Although there was an improvement in the postoperative scores, there was no significant difference between the preoperative and postoperative scores.

Conclusions: A surgical procedure puts a patient through immense psychological stress manifested as low mood and reduced motivation on the part of the patient to participate in their own rehabilitation programme. This affects the overall outcome of a surgical procedure and increases the morbidity. Knowledge of this on part of the operating surgeon and thus proper counselling of the patient, addressing both the psychological and surgical aspects of the disease process will help improve the overall surgical experience.


BPRS, General surgery, Mental status, Perioperative, Psychiatric assessment

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