Authors: Zech N et al.
Anesthesia & Analgesia, 142(5):869–878, May 2026
This prospective, patient-blinded pre–post intervention study investigated whether a focused communication training session for anesthesiologists could further reduce patient anxiety during the preoperative anesthesia consultation. The study is grounded in the concept that traditional risk disclosure—while necessary for informed consent—can unintentionally increase anxiety and create negative expectations, contributing to nocebo effects and worse perioperative experiences.
Patient anxiety was measured before and after the preoperative consultation using validated tools including the State-Trait Anxiety Inventory (STAI-S), a numeric rating scale, and the Amsterdam Preoperative Anxiety and Information Scale (APAIS). After an initial control phase, anesthesiologists participated in a single one-hour communication training session. This training emphasized reframing discussions to include positive aspects of care such as monitoring, prevention strategies, and the treatability of complications, while still appropriately conveying risk.
Across 673 patients, the preoperative consultation itself reduced anxiety in the majority of patients (85%), confirming the inherent value of the anesthesia visit. However, the intervention group—patients seen by trained anesthesiologists—demonstrated a significantly greater reduction in anxiety compared to the control group (approximately 89.5% vs 81.5%). Overall anxiety scores decreased modestly in both groups, but the improvement was more pronounced following communication training. The largest effect was seen in anesthesia-related anxiety, which decreased by approximately 11%. Importantly, patients with higher baseline anxiety experienced the greatest benefit from the intervention, showing a significantly larger reduction in STAI-S scores compared to controls.
The findings demonstrate that even a brief, one-hour communication training session can meaningfully enhance the effectiveness of preoperative consultations in reducing patient anxiety. By shifting how information is delivered—without altering the content of informed consent—anesthesiologists can mitigate negative expectations and improve patient experience.
The authors conclude that structured communication training is a feasible, scalable, and effective intervention that enhances anxiety reduction during preoperative consultations and should be considered an important component of routine anesthesia practice.
What You Should Know
The preoperative anesthesia visit already reduces patient anxiety, but targeted communication training makes it significantly more effective—especially in high-anxiety patients. A simple one-hour training session that emphasizes positive framing and reassurance can measurably improve patient experience without changing clinical care.
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