Everything was fine at the doctor’s office that day as they explained why you needed surgery. You were calm and collected and even helped pick an ideal date for the procedure. Now, your mind is running nonstop worst-case scenarios, there’s an impromptu drum solo in your chest and you have an invisible swarm of butterflies churning your stomach.
It’s almost D-day, and suddenly, the prospect of being unconscious while strangers — albeit qualified ones — rearrange your insides has you contemplating a sprint in the opposite direction of the hospital. Pre-op anxiety is completely normal and entirely manageable. Here’s how to transform that wave into a manageable ripple.
Key Highlight
- Pre‑op anxiety is common but can be managed with proper preparation and mindfulness techniques.
- Openly discussing your concerns significantly reduces anxiety levels.
- Knowing what happens during pre-op assessments demystifies the process, alleviating fear of the unknown.
- Simple relaxation practices — visualization, guided imagery, deep breathing and muscle relaxation — can effectively calm your nervous system before your surgery.
What Exactly Happens During a Pre-Op Assessment?
The pre-op assessment is a checkpoint anyone scheduled for surgery goes through to assess physical and mental readiness for the operating room (OR).(1) This typically happens during the month before your scheduled procedure.(2)
Medical professionals use this time to gather crucial information to ensure your surgery proceeds as safely as possible. During this appointment, expect a comprehensive review of your medical history and a thorough physical examination complete with laboratory tests — blood work, urinary analysis and possibly an electrocardiogram (ECG). You’ll also have imaging studies if needed.
You will talk directly with the surgeon and nurses and even meet with an anesthesiologist to discuss your options and risks. This is also when presurgical instructions specific to your procedure are given.
How to Manage Anxiety During Your Pre-Op Assessment
Most patients report worrying about their upcoming surgeries, whether elective or emergent. A team of researchers recently observed 105 patients aged 18 to 65 undergoing elective surgery over three perioperative sessions — before, during and after the procedures. The results were interesting. The biggest concern (41%) was the fear of feeling pain, followed by 33.3% who were apprehensive of the outcome and 32.40% who worried about their family’s well-being.(3)
There’s a perfectly logical reason behind these high numbers. The body doesn’t distinguish between stress triggered when a predator is chasing you and the tension that brews from anxiety or fear of a surgical procedure. Both activate the same fight-or-flight response that may present the following symptoms:
- Feeling on edge
- A racing heartbeat that may be accompanied by sweating
- Difficulty falling and staying asleep
- Gastrointestinal disturbances
- Trouble focusing on tasks or holding long conversations
High preoperative anxiety can negatively impact surgical outcomes, which could manifest as a heightened pain perception or longer recovery times.(3)
Step 1: Recognize and Reframe Your Fears
Anxiety often springs from fear of the unknown. Acknowledging your fears and reframing them into natural signals will help change your mindset and loosen anxiety’s grip.
Step 2: Prepare Adequately
Knowledge truly is power when it comes to averting presurgical nerves. Be open with the medical team working on your case to address these jitters.
Your doctor wants you to be as comfortable as possible, but they can’t address concerns they don’t know. Discussing your anxieties with your health care providers will help alleviate some of your apprehensions, possibly resulting in a smooth surgical experience. Over 30% of patients feel they would have had lower anxiety levels on the day of surgery had they been more informed.(3)
This is also when your surgical team provides critical preoperative instructions that you must observe for successful outcomes. In most cases, you need to temporarily discontinue certain medications like aspirin and blood thinners approximately one week before your procedure. These medications can interfere with your body’s clotting ability, without which you would bleed excessively during and after the procedure.(4)
You’ll also receive specific instructions to observe on D-day. Typically, you’ll be advised not to consume anything other than water for at least eight hours pre-op. This is because anesthesia relaxes muscles, and if it affects those that prevent stomach contents from going to the lungs, you risk aspiration.
Step 3: Master Evidence-Based Anxiety Management Techniques
Beyond naming your worries, these non‑drug approaches help manage anxiety.(5)
- Immersive virtual reality (VR) sessions before surgery promote preparedness, lowering anxiety.
- Guided imagery relaxation therapy has also been shown to halve self‑reported anxiety among cardiac surgery patients.
- Systematically tensing and then relaxing each muscle group sends a “you’re safe” signal to your brain, while taking deliberate, slow, deep breaths helps override your fight‑or‑flight response.(6)
- Do something that calms and grounds you, such as listening to mellow music, hanging out with family and friends, diving into a book or audiobook, puttering in the garden or even having a hearty laugh. This can effectively redirect your mind away from surgical worries.
- Practicing mindfulness exercises for just 20 minutes every day during the week before surgery could help keep stress hormone (cortisol) levels low before and on the day of the procedure. Mindful meditation exercises like yoga trigger the release of feel-good neurotransmitters that elevate mood, averting the effects of cortisol.(7)
Step 4: Make Use of Your Support Systems
Did you know that women are more likely than men to develop anxiety disorders? However, men are still less likely to seek help for anxiety.(8)
Your social network can be a powerful anxiety buffer. Leverage your family, close friends, therapist and other health care professionals around you. Patients with active support systems had lower preoperative stress hormone levels than those facing surgery alone.(9)
When to Consider Additional Help
If it feels like nothing — not even these self-management techniques — seems to calm your pre-surgery jitters, consider consulting a trained professional for psychological support.
Seek additional help if you experience the following:
- Thoughts of canceling the necessary surgery due to fear
- Panic attacks whenever thinking about your surgery
- Chronic insomnia or recurring nightmares related to your procedure
- Physical symptoms like nausea, dizziness or chest pain when discussing your procedure that seem to be increasing in intensity and frequency
You’ve Got This
The research is clear — with preparation, mindfulness and open communication, you can transform that anxiety into useful energy for your healing journey. After all, you’re in qualified hands. These steps let you reclaim control, calm your nerves and enter the OR with a clear mind, ready for the best possible outcome.