The Anxious Airway: Correlation Between Preoperative Anxiety Scores and Hemodynamic Instability During Endotracheal Intubation

Background: Laryngoscopy and endotracheal intubation elicit a reflex sympathetic response mediated by glossopharyngeal and vagus nerve afferents, resulting in transient hypertension and tachycardia. While preoperative anxiety elevates baseline catecholamines, whether anxiety intensity reliably predicts the magnitude of hemodynamic instability during airway manipulation remains unclear. Objectives: This prospective observational study assessed the relationship between preoperative anxiety scores and hemodynamic responses during the induction of general anesthesia and endotracheal intubation. Methods: One hundred adults (ASA physical status I–III) were consecutively enrolled and underwent elective surgery under general anesthesia. Preoperative anxiety was assessed using the Hamilton Anxiety Rating Scale (HAM-A). Patients were categorized as having mild (