Mind over surgery: evaluating the effectiveness of mindfulness-based interventions in alleviating preoperative anxiety

Preoperative anxiety is a prevalent and clinically significant issue that adversely affects surgical outcomes, anesthetic requirements, postoperative recovery, and overall patient experience. As healthcare systems increasingly emphasize holistic and patient-centered care, mindfulness-based interventions (MBIs) have emerged as promising non-pharmacological strategies for addressing psychological distress prior to surgery. This integrative review synthesizes evidence from 40 studies, including randomized controlled trials (RCTs), quasi-experimental designs, cohort studies, mixed-method investigations, and qualitative analyses, to evaluate the effectiveness of MBIs in reducing preoperative anxiety among adult surgical patients. Across diverse surgical populations-ranging from general, orthopedic, cardiac, and oncologic to ambulatory and gynecologic procedures-MBIs consistently produced meaningful reductions in anxiety. Brief mindfulness practices, such as 5-15-minute breathing and awareness exercises, demonstrated rapid effectiveness, making them suitable for fast-paced clinical environments. More structured programs, including mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), produced the greatest benefits, especially in high-anxiety groups such as oncology and cardiac patients. Physiological improvements, including reduced heart rate, blood pressure, and cortisol levels alongside increased heart-rate variability, support the psychological findings and highlight the mind-body regulatory mechanisms involved. Qualitative evidence further revealed enhanced emotional grounding, reduced fear of anesthesia and surgical uncertainty, and improved perceived control. Overall, MBIs represent accessible, safe, cost-effective, and versatile interventions that can be integrated into modern preoperative care pathways. Their incorporation has the potential to improve emotional resilience, patient satisfaction, and perioperative outcomes.