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Preoperative Anxiety and Its Impact on Intraoperative Hemodynamics and Postoperative Pain, Edema, and Trismus in Orthognathic Surgery

The Effect of Preoperative Anxiety Levels on Intraoperative Hemodynamic Parameters and Postoperative Edema, Pain, and Trismus in Patients Undergoing Bimaxillary Orthognathic Surgery: A Prospective Observational Study

Status
Recruiting
Phases
Unknown
Study type
Observational
Source
ClinicalTrials.gov
Registry ID
NCT07439679
Enrollment
45
Registered
2026-02-27
Start date
2025-02-01
Completion date
2026-04-01
Last updated
2026-02-27

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Dentofacial Deformities

Keywords

orthognathic surgery, preoperative anxiety, facial edema

Brief summary

This study aims to investigate the relationship between preoperative anxiety and intraoperative hemodynamic changes, as well as postoperative pain and facial edema, in patients undergoing orthognathic surgery. Orthognathic surgery is a corrective jaw surgery performed to treat dentofacial deformities. Although the procedure improves functional and aesthetic outcomes, patients may experience significant anxiety before surgery. Elevated anxiety levels may influence physiological responses during the operation and may affect postoperative recovery. In this study, preoperative anxiety levels will be evaluated using validated assessment scales prior to surgery. During the intraoperative period, hemodynamic parameters such as heart rate and blood pressure will be recorded. After surgery, postoperative pain and facial edema will be assessed using standardized clinical evaluation methods. The objective of this research is to determine whether higher levels of preoperative anxiety are associated with changes in intraoperative hemodynamic stability and increased postoperative discomfort. The findings may contribute to improved perioperative management strategies and enhanced patient care in orthognathic surgery.

Detailed description

This prospective, single-center clinical study is being conducted at the Department of Oral and Maxillofacial Surgery, Istanbul Medipol University. The aim of the study is to evaluate the effect of preoperative anxiety levels on intraoperative hemodynamic parameters and postoperative facial edema, pain, and trismus in patients undergoing bimaxillary orthognathic surgery. Patients classified as ASA I or ASA II and scheduled to undergo Le Fort I osteotomy combined with bilateral sagittal split ramus osteotomy are being included in the study. Patients with a history of previous orthognathic surgery, psychiatric disorders, systemic diseases that may affect healing, active smoking, pregnancy, or incomplete questionnaire responses are being excluded. Preoperative anxiety levels are being assessed using the State-Trait Anxiety Inventory (STAI-I and STAI-II). Based on STAI-I scores, patients are being categorized into low-anxiety and high-anxiety groups. During the intraoperative period, systolic arterial pressure, diastolic arterial pressure, mean arterial pressure, heart rate, and peripheral oxygen saturation are being recorded at predefined time intervals. Postoperative evaluations are being performed at 1 hour, 1 day, 2 days, 5 days, 10 days, and 1 month after surgery. Facial edema is being measured using a three-dimensional digital facial scanning system, pain intensity is being assessed using the Visual Analog Scale (VAS), and maximum mouth opening is being measured to determine the degree of trismus.

Interventions

None listed

Sponsors

Istanbul Medipol University Hospital
Lead SponsorOTHER

Study design

Observational model
COHORT
Time perspective
PROSPECTIVE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* ASA physical status I or II * Patients scheduled for bimaxillary orthognathic surgery (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) * Ability to understand and complete the STAI questionnaire * Provision of written informed consent

Exclusion criteria

* Previous orthognathic surgery * History of maxillofacial trauma * History of radiotherapy or chemotherapy in the head and neck region * Presence of psychiatric disorders or current use of psychiatric medications * Chronic systemic disease affecting bone metabolism or wound healing * Active smoking or substance abuse * Pregnancy or lactation * Incomplete questionnaire responses * Inability to attend follow-up visits

Design outcomes

Primary

MeasureTime frameDescription
Postoperative Facial EdemaPostoperative 1 hour to 1 monthFacial edema measured using a three-dimensional digital facial scanning system at postoperative 1 hour, 1st, 2nd, 5th, and 10th days and 1 month.

Secondary

MeasureTime frameDescription
Postoperative Pain (VAS)Postoperative 1 hour to 1 monthPain intensity assessed using a Visual Analog Scale (VAS).
Maximum Mouth Opening (Trismus)Postoperative 1 hour to 1 monthMaximum interincisal distance measured in millimeters to evaluate trismus.
Systolic Blood PressureIntraoperative periodIntraoperative systolic blood pressure measured in mmHg.
Diastolic Blood PressureIntraoperative period (from induction of anesthesia to completion of surgery)Intraoperative diastolic blood pressure measured in millimeters of mercury (mmHg) during orthognathic surgery under general anesthesia.
Mean Arterial PressureIntraoperative period (from induction of anesthesia to completion of surgery)Mean arterial pressure recorded intraoperatively in millimeters of mercury (mmHg) to assess hemodynamic stability during surgery.
Heart RateIntraoperative period (from induction of anesthesia to completion of surgery)Heart rate recorded intraoperatively in beats per minute (bpm) to evaluate cardiovascular response during surgery.
Peripheral Oxygen Saturation (SpO2)Intraoperative period (from induction of anesthesia to completion of surgery)Peripheral oxygen saturation (SpO2) measured intraoperatively using pulse oximetry to assess oxygenation status.

Countries

Turkey (Türkiye)

Contacts

CONTACTMerve Gaye Akgök, DDS
merve.akgok@std.medipol.edu.tr+905064571329
STUDY_CHAIRTuba Develi, Dr

Medipol University

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Feb 28, 2026