Surgery is scary.

And I’m not the only one who feels that way. Research suggests that most people who are about to go into surgery get anxious about it.

I mean, it’s totally justified.  When you undergo major surgery, the worst case scenario is a possibility. And, well, some studies  have found that preoperative anxiety influences postoperative outcomes. So just keep calm and recover from surgery faster?

Yeah, it might actually work that way. [♪ INTRO] If you feel surgery anxiety,  you’re definitely not alone. One study published in 2022  surveyed 400 people a few days before they had surgeries, and  most of them were classified as having high or very high surgery anxiety. The survey used in this study is called the State-Trait Anxiety Inventory, and it measures how intense the responder’s anxiety  is.

If you’re taking it, you answer questions about your  anxiety with a 1 through 4, with higher numbers indicating  more of the feeling. Since there are 20 questions, the  minimum total score is 20 points. So if the participants had a  final score over 40 points, they were put in the surgery  anxiety group of the study.

And 60.5% of the participants  fell into that category. Which means that most people were anxious about their upcoming surgery.  And for some of them, that anxiety was associated with worse outcomes. Specifically, more people who were anxious about high-risk surgeries experienced  postoperative complications.

In this study, “high risk” meant  surgeries such as gastrectomies and esophageal resections, many of which require removing all or part of a tissue. “Complications” referred to a giant  variety of postoperative events, from something you can take medicine  for and recover from at home, to something that requires  another surgery to improve, to something that kills you. Which is why so many people have surgery anxiety! People who were less anxious about  their upcoming high-risk surgery ended up having complications  in 31.4% of the cases.

That’s compared to people who were more anxious about their high-risk surgery, who ended up having complications in 45.2% of the cases. So, significantly more anxious  people had post-surgery complications than their less anxious peers. But that doesn’t necessarily mean that anxiety is what caused the complications.

Maybe these people were more anxious because they really had more to be anxious about. Or maybe their anxiety got in  the way of their own health. It’s a classic chicken-or-egg question: Were they anxious because  their surgeries were riskier, or did anxiety create more complications for them?

To answer at least part of that question, let’s go back in time to a  2019 study that investigated anxiety in 20 people getting brain surgery. By pretty much any standard, brain surgery qualifies as a high-risk operation. So we’re still comparing people who were more anxious and less anxious  before a high-risk surgery.

But this time, everyone was  going in for the same operation, so there was similar risk involved in each case. And everyone was awake, so  researchers could ask them how they felt before, during,  and after their brain surgery. You heard me.

It’s pretty  common for people to be awake for their brain surgeries because it helps the surgeon know what part of the brain they’re poking around in based on the patient’s response. But, of course, there are still plenty  of pain meds and local anesthesia. In fact, in this study, the  researchers found that anxiety was not related to pain during surgery at all.

People who were more anxious  before their brain surgery didn’t feel more pain when  the surgery was happening than people who were less anxious about it. The difference between more  and less anxious people turned out to be pain after the surgery. People with surgery anxiety said that they experienced more postoperative pain.

So the surgery itself wasn’t  more risky or painful, and being awake for the surgery didn’t make people more anxious than they already were. But people with surgery anxiety  still reported tougher recoveries. And some researchers think  that’s because of how they slept.

This idea suggests that anxiety  is just the tip of the iceberg. See, it often goes hand in  hand with a lack of sleep. It may not be surprising that  anxiety can keep you up at night.

But a lot of your body’s  healing happens while you sleep, so this anxiety-sleep association could be related to the tougher recoveries reported. One study published in 2023 investigated this idea by assessing 330 people all going in for the same laparoscopic gynecological surgery. Modern medicine can put a camera almost anywhere!

These researchers split  the study participants into those with high and low surgery anxiety, just like the previous studies  did. And they found that high-anxiety patients had more trouble sleeping after their surgeries and reported  more pain during the recovery period. To the point where people who had surgery anxiety ended up with longer hospital  stays, filled with more vomiting and higher doses of pain medicine.

And cortisol may be at the root of it all. Cortisol is a stress hormone that  dampens down the immune system, which, you know, you need to heal your body. So people with surgery anxiety  may be making more of a hormone that lowers their immune  response, and sleeping less, giving their bodies less  opportunity to take advantage of any immune response that’s  happening.

In the end, they don’t always recover from surgery as  well as less anxious people do. Maybe the best thing to do  going into a surgery is trust the process and believe that  everything will be okay. But if that’s not your vibe, you’re  still probably going to recover from that surgery just fine.  Even in the more anxious groups, most people had no complications.

And, importantly, for lower risk  surgeries, there was no difference between the more and less anxious groups. Not to mention, in these  studies, death rates were not affected by anxiety across the board. Also, all of these findings  were based on correlations, not controlled experiments.  In fact, some analyses have found no significant difference  between more and less anxious people.

But at minimum, none of them  suggest that going into surgery with a serene state of mind is bad for you. And some of them suggest it can help. So keeping calm might really help you carry on!

Here at SciShow, our patrons help us carry on. By contributing $8 a month, you  not only keep the show running, but you also get to hear an  exclusive monthly podcast! In that podcast, the SciShow  team answers Patron questions, provides commentary on previous videos, and goof around playing games.

It’s a fun community that we’d love you to be a part of over at patreon.com/scishow. [♪ OUTRO]