Introduction
Anxiety is a common and significant problem in patients who need to undergo colonoscopy[1]. The efficacy of mindfulness-based stress reduction (MBSR) in alleviating anxiety during the rehabilitation of chronic disease patients has been well-documented[2]. However, limited evidence exists on the application of brief MBSR in patients with preoperative anxiety undergoing colonic endoscopic submucosal dissection (ESD) and its potential effects on bispectral index (BIS).
Results & Findings
A total of 120 patients scheduled for colonoscopy-assisted colonic ESD at the First Affiliated Hospital of Zhengzhou University from January 2024 to December 2024 were enrolled （Approval No.2024-KY-1063-001）. Patients were randomly divided into two groups (n=60) using a random number table: the brief MBSR group (Group M) and the control group (Group C).
Compared with Group C, Group M exhibited significantly lower APAIS scores (21.28 ± 4.53 vs. 12.36 ± 2.90), reduced BIS values (96.42 ± 10.03 vs. 73.86 ± 3.60), and slower heart rates (HR: 85.52 ± 11.78 vs. 64.22 ± 4.54) at both T1 and T2. At T3, Group M also demonstrated lower APAIS scores (16.90 ± 1.78 vs. 15.30 ± 3.46) and higher patient satisfaction scores (10.00 ± 0.00 vs. 7.94 ± 0.87) (P < 0.05). No statistically significant differences were observed between the groups in SBP, DBP,MAP, postoperative adverse events, or PACU recovery time at any time points (P > 0.05).
Summary & Discussion
Brief Mindfulness-Based Stress Reduction (MBSR) reduces Amsterdam Preoperative Anxiety and Information Scale (APAIS) scores. The underlying mechanism involves enhancing individuals' awareness and acceptance of the present moment[3], modulating negative emotional responses, and elevating mindfulness levels, thereby alleviating preoperative anxiety.
MBSR reduces the BIS, and the proposed mechanism may involve a shift in dominant EEG activity from beta waves (associated with wakefulness and focused attention, BIS range 85–100) to alpha waves (linked to relaxation and closed-eye states, BIS range 65–85, median 70) and theta waves (observed during light sleep and REM sleep). This aligns with prior studies demonstrating that MBSR enhances alpha and theta wave activity in specific brain regions[4].
Brief Mindfulness-Based Stress Reduction (MBSR) significantly improved patient satisfaction. By replacing preoperative negative emotions such as tension and anxiety with mindful awareness, the intervention reduced anxiety-related adverse reactions[2]., enhanced procedural comfort and treatment adherence, and fostered a more positive humanistic care experience. These findings suggest that short-term MBSR serves as a valuable psychological adjunct to optimize patient-centered outcomes in clinical settings.
Conclusion
Brief MBSR effectively alleviated preoperative anxiety in patients undergoing colonic ESD, modulated the spectral components and neural oscillatory activity of EEG waves, and reduced BIS values.
References
[1]Chen YS, Feng GH, Yue QQ, Wang YF, Liu M, Zhao KH, Tang T, Huang MT, Yi WT, Yan HL, Yan JH, Zeng Y. Effects of non-pharmacological interventions on anxiety in patients undergoing colonoscopy: A network meta-analysis of randomized controlled trials. J Psychosom Res. 2025 Apr;191:112065. doi: 10.1016/j.jpsychores.2025.112065. Epub 2025 Feb 19. PMID: 40043571.
[2]Xu L, Guan A, Huang Y. Effects of online mindfulness-based interventions on mental and physical health outcomes in cancer patients: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2025 Mar 21;104(12):e41870. doi: 10.1097/MD.0000000000041870. PMID: 40128036; PMCID: PMC11936609.
[3]Reilly A, Sharif A, Bhagra O, Dominari A, Katsos K, Nathani KR, Johnson SE, Bydon M. Evaluation of mindfulness-based interventions for pain, anxiety, and depression in spinal cord injury patients: A systematic review and meta-analysis. Clin Neurol Neurosurg. 2025 Apr;251:108839. doi: 10.1016/j.clineuro.2025.108839. Epub 2025 Mar 10. PMID: 40080944.
[4]Lazarou I, Oikonomou VP, Mpaltadoros L, Grammatikopoulou M, Alepopoulos V, Stavropoulos TG, Bezerianos A, Nikolopoulos S, Kompatsiaris I, Tsolaki M; RADAR-AD Consortium. Eliciting brain waves of people with cognitive impairment during meditation exercises using portable electroencephalography in a smart-home environment: a pilot study. Front Aging Neurosci. 2023 May 30;15:1167410. doi: 10.3389/fnagi.2023.1167410. PMID: 37388185; PMCID: PMC10306118.
Disclosure
The authors disclose no conflicts.
