The Association Between Preoperative Anxiety and Pain Severity, Opioid Requirement, Neutrophil-to-Lymphocyte Ratio, and Postoperative Blood Glucose After Gynecologic Laparotomy at Ngoerah Hospital

Authors

  • Fivilia Anjelina Bora Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Dewa Ayu Mas Shintya Dewi Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • I Putu Kurniyanta Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Tjokorda Gde Agung Senapathi Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia https://orcid.org/0000-0002-7479-6190
  • I Made Gede Widnyana Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana Un
  • Putu Pramana Suarjaya Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • I Gusti Ngurah Mahaalit Aribawa Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Tjahya Aryasa EM Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Pontisomaya Parami Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia
  • Otniel Andrians Labobar Department of Anesthesiology and Intensive Care Therapy, Faculty of Medicine, Udayana University, Denpasar, Bali, Indonesia

DOI:

https://doi.org/10.19166/med.v15i2.10969

Keywords:

Preoperative anxiety, gynecologic laparotomy, postoperative pain, opioid requirement

Abstract

Background:

We assessed whether preoperative anxiety is associated with postoperative pain severity, opioid requirement, neutrophil-to-lymphocyte ratio (NLR), and blood glucose after gynecologic laparotomy.

 

Methods:

Prospective cohort at Ngoerah Hospital (May to June 2025). Anxiety was measured preoperatively with APAIS and categorized as non-anxious, mild, moderate, or severe. Outcomes were NRS pain at 6, 12, and 24 hours, total fentanyl in the first 24 hours, and NLR and blood glucose at 6 hours postoperatively. Multivariable analysis used MANCOVA (99% confidence intervals).

 

Result:

Fifty-four patients were included (mean age 41.78 ± 10.58 years). Anxiety distribution was 46.3% non-anxious, 25.9% mild, 24.1% moderate, and 3.7% severe. Higher anxiety was associated with higher NRS at 6 hours (B 0.842; 99% CI 0.475 to 1.209; p < 0.001), 12 hours (B 0.381; 0.247 to 0.515; p < 0.001), and 24 hours (B 0.158; 0.048 to 0.269; p = 0.048). Anxiety was associated with higher 24-hour fentanyl requirement (B 147.8 microg; 99% CI 124.062 to 171.651; p < 0.001), higher postoperative NLR (B 4.31; 99% CI 0.609 to 8.027; p = 0.024), and higher postoperative blood glucose (B 19.4 mg/dL; 99% CI 7.912 to 30.912; p = 0.001).

 

Conclusions:

Higher preoperative anxiety was independently associated with worse pain, greater opioid requirement, and higher postoperative NLR and blood glucose after gynecologic laparotomy.

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Published

2026-03-10

How to Cite

Bora, F. A., Dewi, D. A. M. S., Kurniyanta, I. P., Senapathi, T. G. A., Widnyana, I. M. G., Suarjaya, P. P., … Labobar, O. A. (2026). The Association Between Preoperative Anxiety and Pain Severity, Opioid Requirement, Neutrophil-to-Lymphocyte Ratio, and Postoperative Blood Glucose After Gynecologic Laparotomy at Ngoerah Hospital. Medicinus, 15(2), 75–84. https://doi.org/10.19166/med.v15i2.10969

Issue

Vol. 15 No. 2 (2026): February

Section

Clinical Research

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Copyright (c) 2026 Fivilia Anjelina Bora, Dewa Ayu Mas Shintya Dewi, I Putu Kurniyanta, Tjokorda Gde Agung Senapathi, I Made Gede Widnyana, Putu Pramana Suarjaya, I Gusti Ngurah Mahaalit Aribawa, Tjahya Aryasa EM, Pontisomaya Parami, Otniel Andrians Labobar

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