Effect of the Palming Technique on Preoperative Anxiety and Hemodynamic Responses in Thyroid Surgery: A Prospective, Single-Blind, Randomized Controlled Trial.

AIM: Preoperative anxiety (PA) may adversely affect perioperative management by increasing psychological distress and contributing to hemodynamic fluctuations. This study primarily aimed to evaluate the effect of the palming technique on PA in patients undergoing thyroidectomy and secondarily to examine its influence on perioperative hemodynamic parameters. METHODS: A total of 92 patients were initially recruited; after exclusions and withdrawals, 80 American Society of Anesthesiologists I-II patients remained in the final analysis and were allocated to either the palming group ( n = 40) or the control group ( n = 40). Baseline State-Trait Anxiety Inventory (STAI) scores and vital signs, including heart rate (HR), mean arterial pressure (MAP), and peripheral oxygen saturation (SpO₂), were recorded in the preoperative holding area (T1). After a 15-minute interval, during which the palming group performed the palming technique and the control group received standard care, these parameters were reassessed (T2). Hemodynamic measurements were also recorded before induction (T3) and at 1, 3, 5, and 10 minutes after tracheal intubation (T4-T7). RESULTS: At T2, the palming group had significantly lower STAI scores ( P = 0.005), MAP ( P = 0.003), and HR ( P = 0.020) than the control group. STAI scores significantly decreased in the palming group ( P = 0.001), whereas no significant change was observed in controls ( P = 0.647). No significant between-group difference was observed in the hemodynamic response to intubation ( P > 0.05). CONCLUSION: The palming technique appears to be a feasible, safe, and low-cost nonpharmacological intervention for reducing PA in patients undergoing thyroidectomy. It may also provide favorable short-term effects on preoperative hemodynamic parameters.