Assessment of Patient Fear and Anxiety of Anesthesia before Surgery – A Cross-sectional Study

Background Preoperative fear and anxiety of anesthesia are common and can negatively affect patient safety, perioperative physiology, and recovery outcomes. Understanding the prevalence and predictors of these fears is essential for implementing targeted interventions. Methods This cross-sectional study included 426 adult patients who underwent elective surgery under general anesthesia at Modarres Hospital, Tehran. Data were collected via a validated 23-item anesthesia-related fear questionnaire and the Generalized Anxiety Disorder-7 (GAD-7) scale. Descriptive statistics, correlation analyses, and multivariable ordinal logistic regression were applied. Results Severe fear of anesthesia was reported in 24.6% of the participants, with a mean fear score of 31.5 ± 12.9. Younger patients and females presented significantly higher fear scores (p < 0.05). A positive correlation was found between GAD-7 score and anesthesia-related fear (r = 0.338, p < 0.001). Regression analysis revealed that younger age (OR = 0.98), female sex (OR = 1.67), and higher GAD scores (OR = 1.14) were independent predictors of fear severity. Previous general anesthesia experience was associated with reduced fear, whereas prior spinal anesthesia tended to increase fear levels. Conclusion Preoperative fear of anesthesia is a prevalent concern, particularly among young, female, and anxious patients. Integrating psychological screening (e.g., the GAD-7) into preanesthesia evaluations and providing tailored counseling may help reduce perioperative anxiety and improve surgical outcomes.