51
|
Risk of Pain and Gastrointestinal Complaints at 6Months After Elective Abdominal Surgery. THE JOURNAL OF PAIN 2019; 20:38-46. [DOI: 10.1016/j.jpain.2018.07.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 07/13/2018] [Accepted: 07/31/2018] [Indexed: 02/07/2023]
|
52
|
Burton D, King A, Bartley J, Petrie KJ, Broadbent E. The surgical anxiety questionnaire (SAQ): development and validation. Psychol Health 2018; 34:129-146. [DOI: 10.1080/08870446.2018.1502770] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Dominic Burton
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Amy King
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Jim Bartley
- Department of Otorhinolaryngology – Head and Neck Surgery, Counties Manukau District Health Board, Otahuhu, Auckland, New Zealand
| | - Keith J. Petrie
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Elizabeth Broadbent
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| |
Collapse
|
53
|
Validation of the Turkish Version of the Surgical Fear Questionnaire. J Perianesth Nurs 2018; 33:708-714. [PMID: 30236578 DOI: 10.1016/j.jopan.2017.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 04/18/2017] [Accepted: 05/09/2017] [Indexed: 11/21/2022]
Abstract
PURPOSE Preoperative surgical fear is an emotional reaction that can be observed in many patients who are waiting to undergo a surgical procedure. The Surgical Fear Questionnaire (SFQ) was originally developed to determine the level of fear in patients who are to undergo surgery; this study aims to translate the questionnaire into the Turkish language and to test the validity and reliability of this Turkish version. DESIGN Methodological research model. METHODS The population of this methodological study included the patients who presented to surgical clinics at a university hospital in Turkey between January and August 2016 and were scheduled to undergo elective surgery; the sample involved 405 patients who met the inclusion criteria. FINDINGS Results of the analyses showed that the SFQ can be used with two subscales-the S subscale, which shows the short-term consequences, and the L subscale, which shows the long-term consequences of surgery. The mean score of the patients was 18.03 ± 11.44 on the former, 19.52 ± 11.87 on the latter, and 37.55 ± 21.11 for the entire questionnaire. The Cronbach's α coefficient was 0.96 for the SFQ-S subscale, 0.90 for the SFQ-L subscale, and 0.93 for the entire questionnaire. CONCLUSIONS In this study, the translated SFQ was found to have a similar structure to the original questionnaire and a high level of validity and reliability and therefore can be used in Turkey.
Collapse
|
54
|
Component network meta-analysis identifies the most effective components of psychological preparation for adults undergoing surgery under general anesthesia. J Clin Epidemiol 2018; 98:105-116. [DOI: 10.1016/j.jclinepi.2018.02.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 01/18/2018] [Accepted: 02/14/2018] [Indexed: 10/18/2022]
|
55
|
The Mechanism of Hyperalgesia and Anxiety Induced by Remifentanil: Phosphorylation of GluR1 Receptors in the Anterior Cingulate Cortex. J Mol Neurosci 2018; 65:93-101. [DOI: 10.1007/s12031-018-1072-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 04/20/2018] [Indexed: 01/21/2023]
|
56
|
Burghardt S, Koranyi S, Magnucki G, Strauss B, Rosendahl J. Non-pharmacological interventions for reducing mental distress in patients undergoing dental procedures: Systematic review and meta-analysis. J Dent 2018; 69:22-31. [DOI: 10.1016/j.jdent.2017.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 11/07/2017] [Accepted: 11/13/2017] [Indexed: 12/14/2022] Open
|
57
|
Farquhar JM, Smith PJ, Snyder L, Gray AL, Reynolds JM, Blumenthal JA. Patterns and predictors of pain following lung transplantation. Gen Hosp Psychiatry 2018; 50:125-130. [PMID: 29190571 DOI: 10.1016/j.genhosppsych.2017.11.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 11/16/2017] [Accepted: 11/18/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE Our objective was to examine variability in pain levels following lung transplantation, and examine individual biopsychosocial factors influencing changes in pain. METHOD We performed a retrospective study of a cohort of 150 patients transplanted and discharged from Duke University Hospital between January 2015 and September 2016. During hospitalization and at clinic visits up to two months after discharge, subjective pain ratings were obtained using a 0-10 Numeric Rating Scale. Psychiatric diagnoses of anxiety and depression and Center for Epidemiological Studies - Depression (CES-D) scores collected after hospital discharge were examined as predictors of post-surgery pain. Medical and surgical variables were examined as covariates. RESULTS During hospitalization, pain ratings decreased over time (p<0.001). Predictors of higher pain levels included pre-transplant history of depression (p=0.001) and anxiety (p=0.04), bilateral lung transplant (p=0.03), and lower six-minute walk distance (p=0.02). Two months after discharge, 18% of patients reported continued pain and 34% remained on opioid pain medications. Two months after discharge, more frequent post-operative complications predicted higher pain levels in a univariate analysis (p=0.02) although this relationship was attenuated after adjustment for depression. In a multivariate analysis, elevated CES-D scores (p=0.002), and greater opioid use (p=0.031) predicted higher pain levels 2-months post-discharge. CONCLUSION We conclude that patients with psychiatric comorbidities may be at risk for greater pain, and may require additional strategies for more effective pain management.
Collapse
Affiliation(s)
- Julia M Farquhar
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Patrick J Smith
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA
| | - Laurie Snyder
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Alice L Gray
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - John M Reynolds
- Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - James A Blumenthal
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
| |
Collapse
|
58
|
Hasanzadeh-kiabi F, Negahdari B. Applications of Drug Anesthesia in Control Chronic Pain. J INVEST SURG 2017; 32:232-237. [DOI: 10.1080/08941939.2017.1397230] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Farshad Hasanzadeh-kiabi
- Faculty of Medicine, Department of Anesthesiology, Mazandaran University of Medical Sciences, Sari, Iran
| | - Babak Negahdari
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical sciences, Tehran, Iran
| |
Collapse
|
59
|
Gan TJ. Poorly controlled postoperative pain: prevalence, consequences, and prevention. J Pain Res 2017; 10:2287-2298. [PMID: 29026331 PMCID: PMC5626380 DOI: 10.2147/jpr.s144066] [Citation(s) in RCA: 602] [Impact Index Per Article: 86.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
This review provides an overview of the clinical issue of poorly controlled postoperative pain and therapeutic approaches that may help to address this common unresolved health-care challenge. Postoperative pain is not adequately managed in greater than 80% of patients in the US, although rates vary depending on such factors as type of surgery performed, analgesic/anesthetic intervention used, and time elapsed after surgery. Poorly controlled acute postoperative pain is associated with increased morbidity, functional and quality-of-life impairment, delayed recovery time, prolonged duration of opioid use, and higher health-care costs. In addition, the presence and intensity of acute pain during or after surgery is predictive of the development of chronic pain. More effective analgesic/anesthetic measures in the perioperative period are needed to prevent the progression to persistent pain. Although clinical findings are inconsistent, some studies of local anesthetics and nonopioid analgesics have suggested potential benefits as preventive interventions. Conventional opioids remain the standard of care for the management of acute postoperative pain; however, the risk of opioid-related adverse events can limit optimal dosing for analgesia, leading to poorly controlled acute postoperative pain. Several new opioids have been developed that modulate μ-receptor activity by selectively engaging intracellular pathways associated with analgesia and not those associated with adverse events, creating a wider therapeutic window than unselective conventional opioids. In clinical studies, oliceridine (TRV130), a novel μ-receptor G-protein pathway-selective modulator, produced rapid postoperative analgesia with reduced prevalence of adverse events versus morphine.
Collapse
Affiliation(s)
- Tong J Gan
- Stony Brook University, Stony Brook, NY, USA
| |
Collapse
|
60
|
Ziehm S, Rosendahl J, Barth J, Strauss BM, Mehnert A, Koranyi S. Psychological interventions for acute pain after open heart surgery. Cochrane Database Syst Rev 2017; 7:CD009984. [PMID: 28701028 PMCID: PMC6432747 DOI: 10.1002/14651858.cd009984.pub3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND This is an update of a Cochrane review previously published in 2014. Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention control in adults undergoing open heart surgery for pain, pain medication, psychological distress, mobility, and time to extubation. SEARCH METHODS For this update, we searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, Web of Science, and PsycINFO for eligible studies up to February 2017. We used the 'related articles' and 'cited by' options of eligible studies to identify additional relevant studies. We checked lists of references of relevant articles and previous reviews. We searched the ProQuest Dissertations and Theses Full Text Database, ClinicalTrials and the WHO International Clinical Trials Registry Platform to identify any unpublished material or ongoing trials. We also contacted the authors of primary studies to identify any unpublished material. In addition, we wrote to all leading heart centres in Germany, Switzerland, and Austria to check whether they were aware of any ongoing trials. SELECTION CRITERIA Randomised controlled trials comparing psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery. DATA COLLECTION AND ANALYSIS Two review authors (SZ and SK) independently assessed trials for eligibility, estimated the risk of bias and extracted all data. We calculated effect sizes for each comparison (Hedges' g) and meta-analysed data using a random-effects model. We assessed the evidence using GRADE and created 'Summary of findings' tables. MAIN RESULTS We added six studies to this update. Overall, we included 23 studies (2669 participants).For the majority of outcomes (two-thirds), we could not perform a meta-analysis since outcomes were not measured, or data were provided by one trial only.No study reported data on the number of participants with pain intensity reduction of at least 50% from baseline. Only one study reported data on the number of participants below 30/100 mm on the Visual Analogue Scale (VAS) in pain intensity (very low-quality evidence). Psychological interventions did not reduce pain intensity in the short-term interval (g 0.39, 95% CI -0.18 to 0.96, 2 studies, 104 participants, low-quality evidence), medium-term interval (g -0.02, 95% CI -0.24 to 0.20, 4 studies, 413 participants, moderate-quality evidence) or in the long-term interval (g 0.05, 95% CI -0.20 to 0.30, 2 studies, 200 participants, moderate-quality evidence).No study reported data on median time to re-medication or on number of participants re-medicated. Only two studies provided data on postoperative analgesic use in the short-term interval, showing that psychological interventions did not reduce the use of analgesic medication (g 1.18, 95% CI -2.03 to 4.39, 2 studies, 104 participants, low-quality evidence). Studies revealed that psychological interventions reduced mental distress in the medium-term (g 0.37, 95% CI 0.13 to 0.60, 13 studies, 1388 participants, moderate-quality evidence) and likewise in the long-term interval (g 0.32, 95% CI 0.10 to 0.53, 14 studies, 1586 participants, moderate-quality evidence). Psychological interventions did not improve mobility in the medium-term interval (g 0.23, 95% CI -0.22 to 0.67, 3 studies, 444 participants, low-quality evidence), nor in the long-term interval (g 0.09, 95% CI -0.10 to 0.28, 4 studies, 458 participants, moderate-quality evidence). Only two studies reported data on time to extubation, indicating that psychological interventions reduced the time to extubation (g 0.56, 95% CI 0.08 to 1.03, 2 studies, 154 participants, low-quality evidence).Overall, the very low to moderate quality of the body of evidence on the efficacy of psychological interventions for acute pain after open heart surgery cannot be regarded as sufficient to draw robust conclusions.Most 'Risk of bias' assessments were low or unclear. We judged selection bias (random sequence generation) and attrition bias to be mostly low risk for included studies. However, we judged the risk of selection bias (allocation concealment), performance bias, detection bias and reporting bias to be mostly unclear. AUTHORS' CONCLUSIONS In line with the conclusions of our previous review, there is a lack of evidence to support or refute psychological interventions in order to reduce postoperative pain in participants undergoing open heart surgery. We found moderate-quality evidence that psychological interventions reduced mental distress in participants undergoing open heart surgery. Given the small numbers of studies, it is not possible to draw robust conclusions on the efficacy of psychological interventions on outcomes such as analgesic use, mobility, and time to extubation respectively on adverse events or harms of psychological interventions.
Collapse
Affiliation(s)
- Susanne Ziehm
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | - Jenny Rosendahl
- University Hospital of JenaInstitute of Psychosocial Medicine and PsychotherapyStoystrasse 3JenaThuringiaGermany07743
| | - Jürgen Barth
- UniversityHospital and University of ZurichInstitute for Complementary and Integrative MedicineSonneggstrasse 6ZurichSwitzerlandCH‐8091
| | - Bernhard M Strauss
- University Hospital of JenaInstitute of Psychosocial Medicine and PsychotherapyStoystrasse 3JenaThuringiaGermany07743
| | - Anja Mehnert
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | - Susan Koranyi
- University Hospital of LeipzigInstitute of Medical Psychology and Medical SoziologyPhilipp‐Rosenthal‐Straße 55LeipzigSaxonyGermany4103
| | | |
Collapse
|
61
|
Jakobsson J, Idvall E, Kumlien C. Patient characteristics and surgery-related factors associated with patient-reported recovery at 1 and 6 months after colorectal cancer surgery. Eur J Cancer Care (Engl) 2017; 26. [DOI: 10.1111/ecc.12715] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2017] [Indexed: 12/31/2022]
Affiliation(s)
- J. Jakobsson
- Faculty of Health and Society; Department of Care Science; Malmö University; Malmö Sweden
- Department of Surgery; Skåne University Hospital; Malmö Sweden
| | - E. Idvall
- Faculty of Health and Society; Department of Care Science; Malmö University; Malmö Sweden
| | - C. Kumlien
- Faculty of Health and Society; Department of Care Science; Malmö University; Malmö Sweden
- Department of Vascular Diseases; Skåne University Hospital; Malmö Sweden
| |
Collapse
|
62
|
King A, Bartley J, Johanson DL, Broadbent E. Components of preoperative anxiety: A qualitative study. J Health Psychol 2017; 24:1897-1908. [PMID: 28810456 DOI: 10.1177/1359105317709512] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Limited research has explored preoperative anxiety through qualitative methodologies. This study aimed to identify specific factors that contribute to preoperative anxiety. A total of 17 patients awaiting general, plastic reconstructive and hand, orthopaedic, or ear, nose, and throat/otorhinolaryngology surgery were interviewed about their concerns in a public hospital. Thematic analysis identified five main sources of anxiety: surgical procedures, surgical complications, symptoms, recovery process, and organisation and delivery of care. These themes support current knowledge and identify wider concerns around the hospital environment and recovery. This study may inform the development of future interventions aimed at reducing preoperative anxiety.
Collapse
Affiliation(s)
- Amy King
- The University of Auckland, New Zealand
| | - Jim Bartley
- Counties Manukau District Health Board, New Zealand
| | | | | |
Collapse
|
63
|
Dadgostar A, Bigder M, Punjani N, Lozo S, Chahal V, Kavanagh A. Does preoperative depression predict post-operative surgical pain: A systematic review. Int J Surg 2017; 41:162-173. [DOI: 10.1016/j.ijsu.2017.03.061] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 03/21/2017] [Accepted: 03/22/2017] [Indexed: 02/06/2023]
|
64
|
Ertuğ N, Ulusoylu Ö, Bal A, Özgür H. Comparison of the effectiveness of two different interventions to reduce preoperative anxiety: A randomized controlled study. Nurs Health Sci 2017; 19:250-256. [PMID: 28422388 DOI: 10.1111/nhs.12339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 12/14/2016] [Accepted: 01/14/2017] [Indexed: 12/16/2022]
Abstract
This study was conducted to determine and compare the effectiveness of nature sounds and relaxation exercises for reducing preoperative anxiety. A repeated measures randomized controlled trial design was used. We divided 159 preoperative patients into three groups: nature sounds (n = 53), relaxation exercises (n = 53), and control groups (n = 53). We evaluated anxiety using the visual analog scale and state anxiety inventory scores immediately before, immediately after, and 30 min after interventions in nature sounds and relaxation exercises groups, and silent rest in the control. We found no differences between the measurement values in the intervention groups, but we did observe a difference between the intervention and control groups. The two interventions were similarly effective in reducing preoperative anxiety. These simple and low-cost interventions can be used to reduce preoperative anxiety in surgical clinics.
Collapse
Affiliation(s)
- Nurcan Ertuğ
- School of Nursing, Ufuk University, Ankara, Turkey
| | | | - Ayça Bal
- LÖSANTE Children's and Adult Hospital, Ankara, Turkey
| | | |
Collapse
|
65
|
Beverly A, Kaye AD, Urman RD. SCAMPs for Multimodal Post-Operative Analgesia: A Concept to Standardize and Individualize Care. Curr Pain Headache Rep 2017; 21:5. [DOI: 10.1007/s11916-017-0603-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
|
66
|
Daly B, Young S, Marla R, Riddell L, Junkin R, Weidenhammer N, Dolan J, Kinsella J, Zhang R. Persistent pain after caesarean section and its association with maternal anxiety and socioeconomic background. Int J Obstet Anesth 2017; 29:57-63. [DOI: 10.1016/j.ijoa.2016.10.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Revised: 09/24/2016] [Accepted: 10/09/2016] [Indexed: 11/30/2022]
|
67
|
van Rooijen S, Carli F, Dalton SO, Johansen C, Dieleman J, Roumen R, Slooter G. Preoperative modifiable risk factors in colorectal surgery: an observational cohort study identifying the possible value of prehabilitation. Acta Oncol 2017; 56:329-334. [PMID: 28067102 DOI: 10.1080/0284186x.2016.1267872] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Colorectal cancer (CRC) is the second most prevalent type of cancer in the world. Surgery is the most common therapeutic intervention, and associated with 20-40% reduction in physiological and functional capacity. Postoperative complications occur in up to 50% of patients resulting in higher mortality rates and greater hospital costs. The number and severity of complications is closely related to patients' preoperative performance status. The aim of this study was to identify the most important preoperative modifiable risk factors that could be part of a multimodal prehabilitation program. METHODS Prospectively collected data of a consecutive series of Dutch CRC patients undergoing colorectal surgery were analyzed. Modifiable risk factors were correlated to the Comprehensive Complication Index (CCI) and compared within two groups: none or mild complications (CCI <20), and severe complications (CCI ≥20). Multivariate logistic regression analysis was done to explore the combined effect of individual risk factors. RESULTS In this 139 patient cohort, smoking, malnutrition, alcohol consumption, neoadjuvant therapy, higher age, and male sex, were seen more frequently in the severe complications group (CCI ≥20). Patients with severe complications had significantly longer hospital stay (16 vs. 6 days, p < 0.001). The risk for severe complications was increased in patients with ASA score III [adjusted odds ratio (OR) 4.4, 95% CI 1.04-18.6], and hemoglobin level <7 mmol/l (adjusted OR 3.3, 95% CI 1.3-8.2). Compared to having no risk factors, more than one risk factor increased OR of severe complications (crude OR 5.2, 95% CI 1.8-15). CONCLUSION This study revealed that the risk of getting severe complications increases with the number of risk factors present preoperatively. Several preoperative patient-related risk factors are modifiable. Multimodal prehabilitation may improve patients' preoperative status and should be tested in a multicenter randomized controlled trial. With an international consortium (Copenhagen, Montreal, Paris, Eindhoven) we initiated a randomized controlled trial (NTR5947).
Collapse
Affiliation(s)
| | - Francesco Carli
- Department of Anesthesiology, The Montreal General Hospital, McGill University, Montreal, Canada
| | | | - Christoffer Johansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
- Department of Surgery, Rigshospitalet, University of Copenhagen, Denmark
| | | | - Rudi Roumen
- Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands
| | - Gerrit Slooter
- Department of Surgery, Máxima Medical Center, Veldhoven, The Netherlands
| |
Collapse
|
68
|
Wiles MD, Mamdani J, Pullman M, Andrzejowski JC. A randomised controlled trial examining the effect of acupuncture at the EX-HN3 (Yintang) point on pre-operative anxiety levels in neurosurgical patients. Anaesthesia 2017; 72:335-342. [DOI: 10.1111/anae.13785] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2016] [Indexed: 11/30/2022]
Affiliation(s)
- M. D. Wiles
- Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | - J. Mamdani
- University of Sheffield Medical School; Sheffield UK
| | - M. Pullman
- Sheffield Teaching Hospitals NHS Foundation Trust; Sheffield UK
| | | |
Collapse
|
69
|
Erkilic E, Kesimci E, Soykut C, Doger C, Gumus T, Kanbak O. Factors associated with preoperative anxiety levels of Turkish surgical patients: from a single center in Ankara. Patient Prefer Adherence 2017; 11:291-296. [PMID: 28280304 PMCID: PMC5338979 DOI: 10.2147/ppa.s127342] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Preoperative anxiety and stress are undoubtedly a difficult experience in patients undergoing elective surgery. These unpleasant sensations depend on several factors. The objective of this study was to evaluate the preoperative anxiety levels in a sample of Turkish population, as well as the underlying causes using the Spielberger State-Trait Anxiety Inventory (STAI anxiety) scale. METHODS The study was conducted according to the Declaration of Helsinki and was approved by the local ethical committee. All participants gave written informed consent upon having received detailed information on the study. Upon entry in the study, state and trait anxiety questionnaires were completed by 186 patients scheduled for elective surgery. The influencing factors in regard to age, sex, educational status and others were also reported. RESULTS There was a statistically significant positive correlation between state and trait anxiety scores in this Turkish population. While the most important predictive factors that affected state-STAI scores were age, sex and duration of sleep the night before surgery; educational status and age were the best predictors for determining the variation in trait-STAI scores. CONCLUSION The factors affecting anxiety levels in different populations might vary among different countries. Interestingly, in this sample of Turkish population, the trait anxiety levels were found to be higher from state-anxiety levels, especially in women and less educated people. Thus, doubts about operation and anesthesia are overlooked. This could be attributed to the low to intermediate life standards of people admitted to our hospital.
Collapse
Affiliation(s)
- Ezgi Erkilic
- Department of Anesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey
- Correspondence: Ezgi Erkilic, Department of Anesthesiology and Reanimation, Atatürk Training and Research Hospital, Park Caddesi Rönesans Evleri A-11, Cayyolu, Ankara 06810, Turkey, Tel +90 505 366 3491, Fax +90 312 291 2726, Email
| | - Elvin Kesimci
- Department of Anesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Cem Soykut
- Department of Anesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Cihan Doger
- Department of Anesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Tülin Gumus
- Department of Anesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey
| | - Orhan Kanbak
- Department of Anesthesiology and Reanimation, Atatürk Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
70
|
Robleda G, Sillero-Sillero A, Puig T, Gich I, Baños JE. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery. Rev Lat Am Enfermagem 2016; 22:785-91. [PMID: 25493674 PMCID: PMC4292684 DOI: 10.1590/0104-1169.0118.2481] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 08/18/2014] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES: to analyze the relationship between preoperative emotional state and the
prevalence and intensity of postoperative pain and to explore predictors of
postoperative pain. METHOD: observational retrospective study undertaken among 127 adult patients of
orthopedic and trauma surgery. Postoperative pain was assessed with the verbal
numeric scale and with five variables of emotional state: anxiety, sweating,
stress, fear, and crying. The Chi-squared test, Student's t test or ANOVA and a
multivariate logistic regression analysis were used for the statistical analysis.
RESULTS: the prevalence of immediate postoperative pain was 28%. Anxiety was the most
common emotional factor (72%) and a predictive risk factor for moderate to severe
postoperative pain (OR: 4.60, 95% CI 1.38 to 15.3, p<0.05, AUC: 0.72, 95% CI:
0.62 to 0.83). Age exerted a protective effect (OR 0.96, 95% CI: 0.94-0.99,
p<0.01). CONCLUSION: preoperative anxiety and age are predictors of postoperative pain in patients
undergoing orthopedic and trauma surgery.
Collapse
Affiliation(s)
- Gemma Robleda
- Departamento de Metodología, Gestión Clínica e Investigación, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | | | - Teresa Puig
- Servicio de Epidemiologia Clínica, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Spain
| | - Ignasi Gich
- Servicio de Epidemiologia Clínica, Institut d'Investigació Biomèdica Sant Pau, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona, Spain
| | - Josep-E Baños
- Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, Spain
| |
Collapse
|
71
|
Graham D, Becerril-Martinez G, Tang J. Who is the surgically resilient individual with traumatic spinal cord injury? JOURNAL OF SPINE SURGERY 2016; 2:230-233. [PMID: 27757438 DOI: 10.21037/jss.2016.08.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- David Graham
- Faculty of Medicine, University of Sydney, Sydney, Australia;; TY Nelson Department of Neurology and Neurosurgery, The Children's Hospital at Westmead, Australia
| | | | - Jonathan Tang
- Faculty of Medicine, University of Sydney, Sydney, Australia
| |
Collapse
|
72
|
Kulkarni AR, Pusic AL, Hamill JB, Kim HM, Qi J, Wilkins EG, Roth RS. Factors Associated with Acute Postoperative Pain Following Breast Reconstruction. JPRAS Open 2016; 11:1-13. [PMID: 28713853 DOI: 10.1016/j.jpra.2016.08.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Post-mastectomy breast reconstruction has become an increasingly important component of breast cancer treatment. Unfortunately, some patients experience severe postoperative pain, placing them at risk for increased clinical morbidity and the development of disabling chronic pain. In an attempt to identify at-risk patients, we prospectively evaluated patient characteristics and medical/surgical variables associated with more severe acute post-reconstruction pain. METHODS Women (N = 2207; one-week 82.8% response rate) undergoing breast reconstruction were assessed for pain experience, anxiety, depression, and sociodemographic characteristics prior to surgery. Pain assessments were made preoperatively and postoperative at 1-week using validated survey instruments including the McGill Pain Questionnaire-Short Form (MPQ-SF), Numerical Pain Rating Scale (NPRS), and BREAST-Q Chest and Upper Body scale. Depressive symptoms and anxiety severity were assessed by the Patient Health Questionnaire and Generalized Anxiety Disorders Scale, respectively. Mixed-effects regression modeling was used to examine the relationships between patient characteristics and medical/surgical factors and 1-week postoperative pain. RESULTS Younger age, bilateral reconstruction, and severity of preoperative pain, anxiety and depression were all associated with more severe acute postoperative pain on all the pain measures and BREAST-Q. Comparison of surgical procedure type indicated less severe postoperative pain for PTRAM, DIEP and SIEA reconstructive surgery compared to tissue expander/implant reconstruction. CONCLUSIONS This study identified patients at risk for greater acute postoperative pain following breast reconstruction. These findings will allow plastic surgeons to better tailor postoperative care to improve patient comfort, reduce clinical morbidity, and further enhance patient satisfaction with their surgical outcome.
Collapse
Affiliation(s)
| | | | | | - Hyungjin M Kim
- Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, MI
| | - Ji Qi
- University of Michigan Healthcare Systems, Ann Arbor, MI
| | | | - Randy S Roth
- University of Michigan Healthcare Systems, Ann Arbor, MI
| |
Collapse
|
73
|
Hypnosis in the Perioperative Management of Breast Cancer Surgery: Clinical Benefits and Potential Implications. Anesthesiol Res Pract 2016; 2016:2942416. [PMID: 27635132 PMCID: PMC5011203 DOI: 10.1155/2016/2942416] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 01/15/2023] Open
Abstract
The aim of this review is to summarize data published on the use of perioperative hypnosis in patients undergoing breast cancer surgery (BCS). Indeed, the majority of BCS patients experience stress, anxiety, nausea, vomiting, and pain. Correct management of the perioperative period and surgical removal of the primary tumor are clearly essential but can affect patients on different levels and hence have a negative impact on oncological outcomes. This review examines the effect of clinical hypnosis performed during the perioperative period. Thanks to its specific properties and techniques allowing it to be used as complementary treatment preoperatively, hypnosis has an impact most notably on distress and postoperative pain. During surgery, hypnosis may be applied to limit immunosuppression, while, in the postoperative period, it can reduce pain, anxiety, and fatigue and improve wound healing. Moreover, hypnosis is inexpensive, an important consideration given current financial concerns in healthcare. Of course, large randomized prospective studies are now needed to confirm the observed advantages of hypnosis in the field of oncology.
Collapse
|
74
|
Toward Identifying Moderators of Associations Between Presurgery Emotional Distress and Postoperative Pain Outcomes: A Meta-Analysis of Longitudinal Studies. THE JOURNAL OF PAIN 2016; 17:874-88. [DOI: 10.1016/j.jpain.2016.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/16/2016] [Accepted: 04/14/2016] [Indexed: 02/02/2023]
|
75
|
Aust H, Rüsch D, Schuster M, Sturm T, Brehm F, Nestoriuc Y. Coping strategies in anxious surgical patients. BMC Health Serv Res 2016; 16:250. [PMID: 27406264 PMCID: PMC4941033 DOI: 10.1186/s12913-016-1492-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Accepted: 06/29/2016] [Indexed: 11/18/2022] Open
Abstract
Background Anaesthesia and surgery provoke preoperative anxiety and stress. Patients try to regain control of their emotions by using coping efforts. Coping may be more effective if supported by specific strategies or external utilities. This study is the first to analyse coping strategies in a large population of patients with high preoperative anxiety. Methods We assessed preoperative anxiety and coping preferences in a consecutive sample of 3087 surgical patients using validated scales (Amsterdam Preoperative Anxiety and Information Scale/Visual Analogue Scale). In the subsample of patients with high preoperative anxiety, patients’ dispositional coping style was determined and patients’ coping efforts were studied by having patients rate their agreement with 9 different coping efforts on a four point Likert scale. Statistical analysis included correlational analysis between dispositional coping styles, coping efforts and other variables such as sociodemographic data. Statistical significance was considered for p < 0.05. Results The final analysis included 1205 patients with high preoperative anxiety. According to the initial self-assessment, about two thirds of the patients believed that information would help them to cope with their anxiety (“monitors”); the remainder declined further education/information and reported self-distraction to be most helpful to cope with anxiety (“blunters”). There was no significant difference between these two groups in anxiety scores. Educational conversation was the coping effort rated highest in monitors whereas calming conversation was the coping effort rated highest in blunters. Coping follows no demographic rules but is influenced by the level of education. Anxiolytic Medication showed no reliable correlation to monitoring and blunting disposition. Both groups showed an exactly identical agreement with this coping effort. Demand for medical anxiolysis, blunting or the desire for more conversation may indicate increased anxiety. The use of the internet was independent of the anxiety level and the demand of information. Conclusion Conversation with medical staff proved to be the most popular coping strategy. Acknowledgment of the division between information-seeking and blunting-like personalities is central to supporting the patient’s individual coping efforts. Internet access may be the easiest way to support coping today. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1492-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Hansjoerg Aust
- Department of Anesthesiology and Intensive Care; Philipps-University of Marburg, Baldingerstrasse, D-35033, Marburg, Germany.
| | - Dirk Rüsch
- Department of Anesthesiology and Intensive Care; Philipps-University of Marburg, Baldingerstrasse, D-35033, Marburg, Germany
| | - Maike Schuster
- Philipps-University of Marburg (UKGM StO Marburg), Marburg, Germany
| | - Theresa Sturm
- Philipps-University of Marburg (UKGM StO Marburg), Marburg, Germany
| | - Felix Brehm
- Philipps-University of Marburg (UKGM StO Marburg), Marburg, Germany
| | - Yvonne Nestoriuc
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center, Hamburg-Eppendorf, Martinistrasse 52, 20246, Hamburg, Germany
| |
Collapse
|
76
|
Suffeda A, Meissner W, Rosendahl J, Guntinas-Lichius O. Influence of depression, catastrophizing, anxiety, and resilience on postoperative pain at the first day after otolaryngological surgery: A prospective single center cohort observational study. Medicine (Baltimore) 2016; 95:e4256. [PMID: 27428236 PMCID: PMC4956830 DOI: 10.1097/md.0000000000004256] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The aim was to assess the association between objectified preoperative psychological factors and postoperative pain at the first day after otolaryngological surgery in accordance with other predictors of postoperative pain. Eighty-two (82) patients (59% male, median age 56 years) were included between January and May 2015. The psychological assessment the day before surgery included the Patient Health Questionnaire (PHQ-9), pain catastrophizing scale (PCS), State-Trait Operation Anxiety (STOA) inventory, and the resilience scale (RS-13). On first postoperative day, patients were rated their pain using the questionnaires of the German-wide project Quality Improvement in Postoperative Pain Treatment (QUIPS) including a numeric rating scale (NRS, 0-10) for determination of patient's maximal pain. QUIPS allowed standardized assessment of patients' characteristics, pain parameters, and outcome. The influence of preoperative and postoperative parameters on patients' maximal postoperative pain was estimated by univariate and multivariate statistical analysis. The mean maximal pain was 3.2 ± 2.9. In univariate analysis, higher PHQ-9 score more than 4 (P = 0.010), higher STOA trait anxiety (P = 0.044), and higher STOA total score (P = 0.043) were associated to more postoperative pain. In multivariate analysis higher PHQ-9 score remained an independent predictor for severe pain (beta = 0.302; 95% confidence interval [CI]: 0.054-0.473; P = 0.014). When all parameters were included into multivariate analysis, 2 of all somatic, psychological, and treatment factors were associated with severe maximal pain: more depression (PHQ-9; beta = 0.256; 95% CI: 0.042-0.404; P = 0.017), and use of opioids in the recovery room (beta = 0.371; 95% CI: 0.108-0.481; P = 0.002). Otolaryngological surgery covers the spectrum from low to severe postoperative pain and is therefore a good model for pain management studies. A set of somatic and psychological parameters seems to allow the identification of patients with higher risk for more postoperative pain. This should help to individualize and improve the perioperative pain management.
Collapse
Affiliation(s)
| | | | - Jenny Rosendahl
- Institute of Psychosocial Medicine and Psychotherapy, Jena University Hospital, Germany
| | - Orlando Guntinas-Lichius
- Department of Otorhinolaryngology
- Correspondence: Orlando Guntinas-Lichius, Department of Otorhinolaryngology, Jena University Hospital, Lessingstrasse 2, D-07740 Jena, Germany (e-mail: )
| |
Collapse
|
77
|
Levett DZ, Edwards M, Grocott M, Mythen M. Preparing the patient for surgery to improve outcomes. Best Pract Res Clin Anaesthesiol 2016; 30:145-57. [DOI: 10.1016/j.bpa.2016.04.002] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/01/2016] [Accepted: 04/20/2016] [Indexed: 12/01/2022]
|
78
|
Powell R, Scott NW, Manyande A, Bruce J, Vögele C, Byrne‐Davis LMT, Unsworth M, Osmer C, Johnston M. Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. Cochrane Database Syst Rev 2016; 2016:CD008646. [PMID: 27228096 PMCID: PMC8687603 DOI: 10.1002/14651858.cd008646.pub2] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND In a review and meta-analysis conducted in 1993, psychological preparation was found to be beneficial for a range of outcome variables including pain, behavioural recovery, length of stay and negative affect. Since this review, more detailed bibliographic searching has become possible, additional studies testing psychological preparation for surgery have been completed and hospital procedures have changed. The present review examines whether psychological preparation (procedural information, sensory information, cognitive intervention, relaxation, hypnosis and emotion-focused intervention) has impact on the outcomes of postoperative pain, behavioural recovery, length of stay and negative affect. OBJECTIVES To review the effects of psychological preparation on postoperative outcomes in adults undergoing elective surgery under general anaesthetic. SEARCH METHODS We searched the Cochrane Register of Controlled Trials (CENTRAL 2014, Issue 5), MEDLINE (OVID SP) (1950 to May 2014), EMBASE (OVID SP) (1982 to May 2014), PsycINFO (OVID SP) (1982 to May 2014), CINAHL (EBESCOhost) (1980 to May 2014), Dissertation Abstracts (to May 2014) and Web of Science (1946 to May 2014). We searched reference lists of relevant studies and contacted authors to identify unpublished studies. We reran the searches in July 2015 and placed the 38 studies of interest in the `awaiting classification' section of this review. SELECTION CRITERIA We included randomized controlled trials of adult participants (aged 16 or older) undergoing elective surgery under general anaesthesia. We excluded studies focusing on patient groups with clinically diagnosed psychological morbidity. We did not limit the search by language or publication status. We included studies testing a preoperative psychological intervention that included at least one of these seven techniques: procedural information; sensory information; behavioural instruction; cognitive intervention; relaxation techniques; hypnosis; emotion-focused intervention. We included studies that examined any one of our postoperative outcome measures (pain, behavioural recovery, length of stay, negative affect) within one month post-surgery. DATA COLLECTION AND ANALYSIS One author checked titles and abstracts to exclude obviously irrelevant studies. We obtained full reports of apparently relevant studies; two authors fully screened these. Two authors independently extracted data and resolved discrepancies by discussion.Where possible we used random-effects meta-analyses to combine the results from individual studies. For length of stay we pooled mean differences. For pain and negative affect we used a standardized effect size (the standardized mean difference (SMD), or Hedges' g) to combine data from different outcome measures. If data were not available in a form suitable for meta-analysis we performed a narrative review. MAIN RESULTS Searches identified 5116 unique papers; we retrieved 827 for full screening. In this review, we included 105 studies from 115 papers, in which 10,302 participants were randomized. Mainly as a result of updating the search in July 2015, 38 papers are awaiting classification. Sixty-one of the 105 studies measured the outcome pain, 14 behavioural recovery, 58 length of stay and 49 negative affect. Participants underwent a wide range of surgical procedures, and a range of psychological components were used in interventions, frequently in combination. In the 105 studies, appropriate data were provided for the meta-analysis of 38 studies measuring the outcome postoperative pain (2713 participants), 36 for length of stay (3313 participants) and 31 for negative affect (2496 participants). We narratively reviewed the remaining studies (including the 14 studies with 1441 participants addressing behavioural recovery). When pooling the results for all types of intervention there was low quality evidence that psychological preparation techniques were associated with lower postoperative pain (SMD -0.20, 95% confidence interval (CI) -0.35 to -0.06), length of stay (mean difference -0.52 days, 95% CI -0.82 to -0.22) and negative affect (SMD -0.35, 95% CI -0.54 to -0.16) compared with controls. Results tended to be similar for all categories of intervention, although there was no evidence that behavioural instruction reduced the outcome pain. However, caution must be exercised when interpreting the results because of heterogeneity in the types of surgery, interventions and outcomes. Narratively reviewed evidence for the outcome behavioural recovery provided very low quality evidence that psychological preparation, in particular behavioural instruction, may have potential to improve behavioural recovery outcomes, but no clear conclusions could be reached.Generally, the evidence suffered from poor reporting, meaning that few studies could be classified as having low risk of bias. Overall,we rated the quality of evidence for each outcome as 'low' because of the high level of heterogeneity in meta-analysed studies and the unclear risk of bias. In addition, for the outcome behavioural recovery, too few studies used robust measures and reported suitable data for meta-analysis, so we rated the quality of evidence as `very low'. AUTHORS' CONCLUSIONS The evidence suggested that psychological preparation may be beneficial for the outcomes postoperative pain, behavioural recovery, negative affect and length of stay, and is unlikely to be harmful. However, at present, the strength of evidence is insufficient to reach firm conclusions on the role of psychological preparation for surgery. Further analyses are needed to explore the heterogeneity in the data, to identify more specifically when intervention techniques are of benefit. As the current evidence quality is low or very low, there is a need for well-conducted and clearly reported research.
Collapse
Affiliation(s)
- Rachael Powell
- University of ManchesterSchool of Psychological Sciences and Manchester Centre for Health PsychologyCoupland 1 BuildingOxford RoadManchesterUKM13 9PL
| | - Neil W Scott
- University of AberdeenMedical Statistics TeamPolwarth BuildingForesterhillAberdeenScotlandUKAB 25 2 ZD
| | - Anne Manyande
- University of West LondonSchool of Human and Social SciencesBoston Manor RoadBrentfordLondonUKTW8 9GA
| | - Julie Bruce
- University of WarwickWarwick Clinical Trials UnitGibbet Hill RdCoventryUKCV4 7AL
| | - Claus Vögele
- University of LuxembourgInstitute for Health and Behaviour, Research Unit INSIDERoute de Diekirch ‐ B.P. 2Esch‐sur‐AlzetteLuxembourgL‐4366
| | - Lucie MT Byrne‐Davis
- University of ManchesterManchester Medical SchoolStopford BuildingOxford RoadManchesterUKM13 9PT
| | - Mary Unsworth
- School of Life and Health Sciences, Aston UniversityPsychologyAston TriangleBirminghamUKB4 7ET
| | | | - Marie Johnston
- University of AberdeenInstitute of Applied Health SciencesHealth Sciences Building, 2nd floorForesterhillAberdeenScotlandUKAB25 2ZD
| | | |
Collapse
|
79
|
Kekecs Z, Szeverenyi C, Johnson A, Elkins G, Csernatony Z, Varga K. The Effectiveness of Psychosocial Interventions as Adjuncts to Orthopaedic Surgery: A Systematic Review Protocol. Musculoskeletal Care 2016; 15:69-78. [PMID: 27061940 DOI: 10.1002/msc.1142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
AIMS Pain and anxiety are commonly reported among those undergoing orthopaedic surgery. Improvement in anxiety and pain control might be achieved by supplementing standard care with psychological interventions. However, the effectiveness of adjunctive psychosocial interventions in anxiety and pain control have not been addressed sufficiently by previous systematic reviews in orthopaedic surgeries. The present study aimed to assess the effectiveness of adjunctive psychosocial techniques to improve perioperative clinical care in orthopaedic surgery, to identify the most effective intervention types and to evaluate potential moderators. METHODS We will perform a systematic review and meta-analysis to address the study aims. PubMed, PsycINFO, CINAHL and ProQuest Dissertations & Theses will be searched between 1980 and 2015. Prospective controlled clinical trials completed in adults, contrasting standard care and standard care supplemented with psychosocial methods, will be eligible for inclusion. Effectiveness will be assessed through the outcomes of postoperative pain intensity, analgesic requirement, perioperative anxiety, quality of life and postoperative recovery. The results of a random-effect meta-analysis will be reported. To aid implementation of best practice, moderating effects of the type and timing of psychosocial intervention, type of surgical intervention and type of anaesthesia will be evaluated through meta-regression. Sensitivity analyses and subgroup contrasts will follow as necessary. DISCUSSION Recommendations will be made to improve medical care in orthopaedic procedures. The quality of evidence will be rated using GRADE criteria. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Zoltan Kekecs
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Csenge Szeverenyi
- Department of Orthopedic Surgery, University of Debrecen, Clinical Center, Debrecen, Hungary
| | - Alisa Johnson
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Gary Elkins
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, USA
| | - Zoltan Csernatony
- Department of Orthopedic Surgery, University of Debrecen, Clinical Center, Debrecen, Hungary
| | - Katalin Varga
- Institute of Psychology, Eotvos Lorand University, Budapest, Hungary
| |
Collapse
|
80
|
Le Roy B, Selvy M, Slim K. The concept of prehabilitation: What the surgeon needs to know? J Visc Surg 2016; 153:109-12. [DOI: 10.1016/j.jviscsurg.2016.01.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
|
81
|
Pretreatment of Anxiety Before Cervical Spine Surgery Improves Clinical Outcomes: A Prospective, Single-Institution Experience. World Neurosurg 2016; 88:625-630. [DOI: 10.1016/j.wneu.2015.11.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 10/31/2015] [Accepted: 11/02/2015] [Indexed: 11/23/2022]
|
82
|
Preoperative state anxiety, acute postoperative pain, and analgesic use in persons undergoing lower limb amputation. Clin J Pain 2016; 31:699-706. [PMID: 26153780 DOI: 10.1097/ajp.0000000000000150] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
OBJECTIVES The current study examined the relationship between preoperative anxiety and acute postoperative phantom limb pain (PLP), residual limb pain (RLP), and analgesic medication use in a sample of persons undergoing lower limb amputation. MATERIALS AND METHODS Participants included 69 adults admitted to a large level 1 trauma hospital for lower limb amputation. Participants' average pain and anxiety during the previous week were assessed before amputation surgery. RLP, PLP, and analgesic medication use were measured on each of the 5 days following amputation surgery. RESULTS Results of partial-order correlations indicated that greater preoperative anxiety was significantly associated with greater ratings of average PLP for each of the 5 days following amputation surgery, after controlling for preoperative pain ratings and daily postoperative analgesic medication use. Partial correlation values ranged from 0.30 to 0.62, indicating medium to large effects. Preoperative anxiety was also significantly associated with ratings of average RLP only on postoperative day 1, after controlling for preoperative pain ratings and daily postoperative analgesic medication use (r=0.34, P<0.05). Correlations between preoperative anxiety and daily postoperative analgesic medication dose became nonsignificant when controlling for preamputation and postamputation pain ratings. DISCUSSION These findings suggest that anxiety may be a risk factor for acute postamputation PLP and RLP, and indicate that further research to examine these associations is warranted. If replicated, the findings would support research to examine the extent to which modifying preoperative anxiety yields a reduction in postoperative acute PLP and RLP.
Collapse
|
83
|
Zhao DF, Becerril-Martinez G, Graham D. Neuropeptide Y: Biomarker and intervention for surgical recovery. Neurobiol Stress 2016; 2:60-1. [PMID: 26844240 PMCID: PMC4721280 DOI: 10.1016/j.ynstr.2015.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 05/18/2015] [Indexed: 11/11/2022] Open
Affiliation(s)
- Dong Fang Zhao
- Sydney Medical School, The University of Sydney, Sydney, Australia
| | | | - David Graham
- Sydney Medical School, The University of Sydney, Sydney, Australia; Department of Surgery, Concord Repatriation General Hospital, Sydney, Australia
| |
Collapse
|
84
|
das Nair R, Anderson P, Clarke S, Leighton P, Lincoln NB, Mhizha-Murira JR, Scammell BE, Walsh DA. Home-administered pre-surgical psychological intervention for knee osteoarthritis (HAPPiKNEES): study protocol for a randomised controlled trial. Trials 2016; 17:54. [PMID: 26818407 PMCID: PMC4730777 DOI: 10.1186/s13063-016-1165-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 01/11/2016] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Knee replacement surgery reduces pain for many people with osteoarthritis (OA). However, surgical outcomes are partly dependent on patients' moods, and those with depression or anxiety have worse outcomes. Approximately one-third of people with OA have mood problems. Cognitive behavioural therapy (CBT), a psychological therapy, is recommended by the National Institute for Health and Care Excellence for improving mood. However, evidence for the effectiveness of CBT before knee surgery in improving pain, mood, and quality of life following this surgery for people with knee OA is lacking. METHODS/DESIGN This is a multi-centre, mixed-methods feasibility randomised controlled trial to compare treatment as usual (TAU) plus a brief CBT-based intervention with a TAU-only control, for people with knee OA. We will recruit 50 patients with knee OA, listed for knee replacement surgery, with high levels of distress (assessed using a mood questionnaire), and who consent to take part. Participants will be randomly allocated to receive TAU plus intervention or TAU. Up to 10 sessions of CBT will be offered on an individual basis by a psychologist. The assessments and interventions will be completed before surgery. Repeat assessments at 4 and 6 months after randomisation will be sent and received by post. Two patient-partners will conduct feedback interviews with some participants to assess what aspects of the intervention were helpful or unhelpful, the acceptability of randomisation, the experience of being in a control group, and the appropriateness of the measures used. Interviews will be audio-recorded, transcribed, and analysed using the framework approach. We will examine the feasibility and acceptability of patient-partners conducting the interviews by also interviewing the patient-partners. DISCUSSION Findings from this study will be used to design a definitive study that will examine the clinical and cost-effectiveness of the CBT intervention in improving patient outcomes following knee surgery. TRIAL REGISTRATION Current Controlled Trials ISRCTN80222865; Date: 19 June 2014.
Collapse
Affiliation(s)
- Roshan das Nair
- Division of Rehabilitation & Ageing, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK. .,Department of Clinical Psychology & Neuropsychology, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
| | - Pippa Anderson
- Swansea Centre for Health Economics, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, UK.
| | - Simon Clarke
- Division of Rehabilitation & Ageing, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK. .,Arthritis Research UK Pain Centre, Clinical Sciences Building, City Hospital, Nottingham, NG5 1 PB, UK. .,Physical Health Clinical Psychology Services, Nottinghamshire Healthcare NHS Trust, Pain Management Suite, Clinic 9, King's Mill Hospital, Mansfield, NG17 4JL, UK.
| | - Paul Leighton
- School of Medicine, University of Nottingham, Room 2104, C Floor South Block, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
| | - Nadina B Lincoln
- Division of Rehabilitation & Ageing, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK. .,Arthritis Research UK Pain Centre, Clinical Sciences Building, City Hospital, Nottingham, NG5 1 PB, UK.
| | - Jacqueline R Mhizha-Murira
- Division of Rehabilitation & Ageing, Queens Medical Centre, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Brigitte E Scammell
- Arthritis Research UK Pain Centre, Clinical Sciences Building, City Hospital, Nottingham, NG5 1 PB, UK.
| | - David A Walsh
- Arthritis Research UK Pain Centre, Clinical Sciences Building, City Hospital, Nottingham, NG5 1 PB, UK. .,Academic Rheumatology, University of Nottingham, Clinical Sciences Building, City Hospital, Nottingham, NG5 1 PB, UK.
| |
Collapse
|
85
|
Graham D, Becerril-Martinez G, Quinto L, Zhao DF. Can we measure surgical resilience? Med Hypotheses 2016; 86:76-9. [PMID: 26804602 DOI: 10.1016/j.mehy.2015.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 12/03/2015] [Indexed: 11/29/2022]
Abstract
Surgical resilience describes psychological resilience within a surgical setting. Within a surgical setting, psychologically resilient patients have improved recovery and wound-healing. The search for biological correlates in resilient patients has led to the hypothesis that certain endogenous biomarkers (namely neuropeptide Y (NPY), testosterone, and dehydroepiandrosterone (DHEA)) are altered in resilient patients. The concept of surgical resilience raises the question of whether enhanced recovery following surgery can be demonstrated in patients with high titres of resilience biomarkers as compared to patients with low titres of resilience biomarkers. To determine the prognostic value of resilience biomarkers in surgical recovery, a cohort of patients undergoing major surgery should initially be psychometrically tested for their resilience levels before and after surgery so that biomarker levels of NPY, testosterone and DHEA can be compared to a validated psychometric test of resilience. The primary outcome would be length of hospital stay with and without an enhanced recovery program. Secondary outcome measures such as complications, time in rehabilitation and readmission could also be included. If the hypothesis is upheld, resilience biomarkers could be used to support more individualised perioperative management and lead to more efficient and effective allocation of healthcare resources.
Collapse
Affiliation(s)
- David Graham
- Faculty of Medicine, The University of Sydney, Australia
| | | | - Lena Quinto
- Faculty of Medicine, The University of Sydney, Australia
| | - Dong Fang Zhao
- Faculty of Medicine, The University of Sydney, Australia
| |
Collapse
|
86
|
Wattier JM, Caïazzo R, Andrieu G, Kipnis E, Pattou F, Lebuffe G. Chronic post-thyroidectomy pain: Incidence, typology, and risk factors. Anaesth Crit Care Pain Med 2016; 35:197-201. [PMID: 26808897 DOI: 10.1016/j.accpm.2015.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/04/2015] [Accepted: 10/07/2015] [Indexed: 11/19/2022]
Abstract
Chronic postoperative pain exists in varying degrees for every type of surgery. An evaluation of the incidence, the typology and predictive factors of chronic pain was carried out at 3 and 6months after thyroidectomy. A prospective observational study, having included each of the patients prior to their thyroidectomy, was carried out over 12months. The patients used an 11-point numerical rating scale (NRS), a neuropathic pain screening questionnaire (DN4), an evaluation scale for anxiety and for the need for information related to anaesthesia and surgery (APAIS), a questionnaire describing pain (QDSA) and a questionnaire evaluating neuropathic pain (NPSI) before surgery and at three and six months later. Three hundred and four patients were included. The questionnaires were completed by 251 patients (57 males and 194 females) at 3 and 6months (82%). At 3months, 31 out of 251 (12%) patients mentioned a DN4≥3; at 6months, this rate dropped to 23 out of 251 (9%). The average intensity of chronic postoperative pain remained low to moderate. Levels of anxiety and the need for information were higher in patients with postoperative pain at 3 and 6months. In contrast, the number of intraoperative procedures using a bilateral superficial cervical plexus block (BSCPB) was lower in patients with DN4≥3. Multivariate analysis demonstrated that the type of anaesthesia procedure interfered with the risk of delayed pain after thyroidectomy. The presence of a DN4≥3 was nearly three-fold greater in patients without BSCPB (OR 2.647, CI=1.198-5.848).
Collapse
Affiliation(s)
- Jean-Michel Wattier
- Pôle d'anesthésie réanimation, CHU de Lille, 59000 Lille, France; Rue Michel-Polonovski, 59037 Lille cedex, France.
| | - Robert Caïazzo
- Service de chirurgie générale et endocrinienne, CHU de Lille, 59000 Lille, France; Rue Michel-Polonovski, 59037 Lille cedex, France.
| | - Grégoire Andrieu
- Pôle d'anesthésie réanimation, CHU de Lille, 59000 Lille, France; Rue Michel-Polonovski, 59037 Lille cedex, France.
| | - Eric Kipnis
- Pôle d'anesthésie réanimation, CHU de Lille, 59000 Lille, France; Rue Michel-Polonovski, 59037 Lille cedex, France.
| | - François Pattou
- Service de chirurgie générale et endocrinienne, CHU de Lille, 59000 Lille, France; Rue Michel-Polonovski, 59037 Lille cedex, France.
| | - Gilles Lebuffe
- Pôle d'anesthésie réanimation, University of Lille, CHU de Lille, EA7365-GRITA - Groupe de recherche sur les formes injectables et technologies associées, 59000 Lille, France; Rue Michel-Polonovski, 59037 Lille cedex, France.
| |
Collapse
|
87
|
Thygesen MK, Christensen RDP, Hedemand L, Mogensen O. Change in Preoperative Nervousness: A Randomized Controlled Trial in Gynecological Cancer Patients. Health (London) 2016. [DOI: 10.4236/health.2016.83025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
88
|
Abstract
Chronic pain after surgery is common.Surgery is widely performed therefore the at risk population is large.The mechanisms of chronic pain after surgery are complex.There are many risk factors associated with onset of chronic post-surgical pain: demographic, genetic and medical.Unnecessary and inappropriate surgery should be avoided.
Collapse
Affiliation(s)
- Michael Je Neil
- Consultant Anaesthetists, The Pain Service, Ninewells Hospital and Medical School, Dundee, DD1 9SY
| | - William A Macrae
- Consultant Anaesthetists, The Pain Service, Ninewells Hospital and Medical School, Dundee, DD1 9SY
| |
Collapse
|
89
|
Comprehensive surgical care: less recognized factors in successfull operative treatment. Eur Surg 2015. [DOI: 10.1007/s10353-015-0366-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
90
|
Stessel B, Fiddelers AA, Joosten EA, Hoofwijk DMN, Gramke HF, Buhre WFFA. Prevalence and Predictors of Quality of Recovery at Home After Day Surgery. Medicine (Baltimore) 2015; 94:e1553. [PMID: 26426622 PMCID: PMC4616829 DOI: 10.1097/md.0000000000001553] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Traditionally, major complications and unanticipated admission/readmission rates were used to assess outcome after day surgery. However, in view of the relative absence of major complications the quality of recovery (QOR) should be considered one of the principal endpoints after day surgery. In our study, the level of QOR is defined by a combination of the Global Surgical Recovery (GSR) Index and the Quality of Life (QOL). The aim of this study was to analyze prevalence and predictors of QOR after day surgery on the fourth postoperative day. Elective patients scheduled for day surgery from November 2008 to April 2010 were enrolled in a prospective cohort study. Outcome parameters were measured by using questionnaire packages at 2 time points: 1 week preoperatively and 4 days postoperatively. Primary outcome parameter is the QOR and is defined as good if the GSR index >80% as well as the postoperative QOL is unchanged or improved as compared with baseline. QOR is defined as poor if both the GSR index ≤ 80% and if the postoperative QOL is decreased as compared with baseline. QOR is defined as intermediate in all other cases. Three logistic regression analyses were performed to determine predictors for poor QOR after day surgery. A total of 1118 patients were included. A good QOR was noted in 17.3% of patients, an intermediate QOR in 34.8%, and a poor QOR in 47.8% 4 days after day surgery. The best predictor for poor QOR after day surgery was type of surgery. Other predictors were younger age, work status, and longer duration of surgery. A history of previous surgery, expected pain (by the patient) and high long-term surgical fear were significant predictors of poor QOR in only 1 of 3 prediction models. The QOR at home 4 days after day surgery was poor in the majority of patients and showed a significant procedure-specific variation. Patients at risk for poor QOR can be identified during the preoperative period based on type of surgery, age, work status, and the duration of the surgery.
Collapse
Affiliation(s)
- Björn Stessel
- From the Department of Anesthesiology, Jessa Hospital, Hasselt, Belgium (BS) and Department of Anesthesiology, Maastricht University Medical Center, Maastricht, The Netherlands (BS, AAF, EAJ, DMNH, H-FG, WFFAB)
| | | | | | | | | | | |
Collapse
|
91
|
Bedeutung präoperativer Angst für den postoperativen Verlauf bei urologischen Patienten. Schmerz 2015; 30:166-73. [DOI: 10.1007/s00482-015-0023-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
92
|
Wang H, Cai Y, Liu J, Dong Y, Lai J. Pain sensitivity: a feasible way to predict the intensity of stress reaction caused by endotracheal intubation and skin incision? J Anesth 2015; 29:904-11. [DOI: 10.1007/s00540-015-2040-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Accepted: 06/21/2015] [Indexed: 11/24/2022]
|
93
|
Park JH, Kim HK, Kim KS, Kim ME. Pain Catastrophizing for Patients with Temporomandibular Disorders. ACTA ACUST UNITED AC 2015. [DOI: 10.14476/jomp.2015.40.2.47] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
94
|
Płotek W, Pielok J, Cybulski M, Samborska R. Emotional processes in patients undergoing coronary artery bypass graft surgeries with extracorporeal circulation in view of selected indicators of the inflammatory condition. Med Sci Monit 2015; 21:105-17. [PMID: 25573296 PMCID: PMC4298257 DOI: 10.12659/msm.892372] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background The aim of this study was to describe positive and negative emotions in patients undergoing coronary artery bypass graft (CABG) surgeries with extracorporeal circulation and the correlations between emotions and basic indicators of the inflammatory condition: C-reactive protein (CRP) concentration, body temperature, and leukocyte count. Material/Methods Standardized tools were used to select 52 patients (aged 47–63 years, 6 women – 11.5% and 46 men – 88.5%) without dementia or depression. The Positive and Negative Affect Schedule (PANAS) was used to examine positive affect (PA) and negative affect (NA) and the State-Trait Anxiety Inventory (STAI X1 and X2) was used to examine the anxiety level. The patients underwent CABG surgery according to a common anesthesia protocol and for 5 consecutive days they were observed in the ward, where selected indicators of the inflammatory condition were monitored. Results A detailed description of the results of examinations of emotions was presented. The patients with low PA-trait level, high NA-trait level, and high anxiety-trait level (STAI X2) exhibited statistically significantly higher body temperatures than the other patients in the postoperative period. The patients with high NA-trait and anxiety-state levels (STAI X1) had statistically significantly lower CRP levels in the postoperative period than the patients with low NA-trait and anxiety-state levels (STAI X1). Conclusions Patients undergoing CABG operations express both positive and negative affects. The changes in the inflammatory markers are expressed mostly by CRP concentration. There exist relationships between the result of tests assessing emotions and the markers of the inflammatory condition.
Collapse
Affiliation(s)
- Włodzimierz Płotek
- Department of Teaching Anaesthesiology and Intensive Therapy, Poznań University of Medical Sciences, Poznań, Poland
| | - Joanna Pielok
- Department of Anaesthesiology and Intensive Care, Stanisław Staszic Specialist Hospital, Piła, Poland
| | - Marcin Cybulski
- Department of Clinical Psychology, Poznań University of Medical Sciences, Poznań, Poland
| | - Regina Samborska
- Department of Cardiac Surgery with Intensive Cardiologic Supervision Wards, Józef Struś General Hospital, Poznań, Poland
| |
Collapse
|
95
|
Abstract
Patients who are elderly, malnourished, anxious, and have a low physical function before surgery are likely to have suboptimal recovery from cancer surgery. A multimodal prehabilitation program is proposed, consisting of exercise training and nutritional and psychological support, which increases physiologic reserve before the stress of surgery. This interventional approach seems to improve ability to undergo the stress of surgery and faster recovery. The integration of exercise, adequate nutrition, and psychosocial components, with medical and pharmacologic optimization in the presurgical period, deserves to receive more attention by clinicians to elucidate the most effective interventions.
Collapse
Affiliation(s)
- Francesco Carli
- Department of Anesthesia, McGill University, Montreal, Quebec, Canada.
| | - Celena Scheede-Bergdahl
- Department of Anesthesia, McGill University, Montreal, Quebec, Canada; Department of Kinesiology and Physical Education, McGill University, Montreal, Quebec, Canada
| |
Collapse
|
96
|
Lamacraft G. The transition from acute to chronic pain. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2014. [DOI: 10.1080/22201173.2010.10872650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
97
|
Theunissen M, Peters ML, Schouten EGW, Fiddelers AAA, Willemsen MGA, Pinto PR, Gramke HF, Marcus MAE. Validation of the surgical fear questionnaire in adult patients waiting for elective surgery. PLoS One 2014; 9:e100225. [PMID: 24960025 PMCID: PMC4069058 DOI: 10.1371/journal.pone.0100225] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2013] [Accepted: 05/23/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Because existing instruments for assessing surgical fear seem either too general or too limited, the Surgical Fear Questionnaire (SFQ) was developed. The aim of this study is to assess the validity and reliability of the SFQ. METHODS Based on existing literature and expert consultation the ten-item SFQ was composed. Data on the SFQ were obtained from 5 prospective studies (N = 3233) in inpatient or day surgery patients. These data were used for exploratory factor analysis (EFA), confirmatory factor analysis (CFA), reliability analysis and validity analysis. RESULTS EFA in Study 1 and 2 revealed a two-factor structure with one factor associated with fear of the short-term consequences of surgery (SFQ-s, item 1-4) and the other factor with fear of the long-term consequences of surgery (SFQ-l, item 5-10). However, in both studies two items of the SFQ-l had low factor loadings. Therefore in Study 3 and 4 the 2-factor structure was tested and confirmed by CFA in an eight-item version of the SFQ. Across all studies significant correlations of the SFQ with pain catastrophizing, state anxiety, and preoperative pain intensity indicated good convergent validity. Internal consistency (Cronbach's alpha) was between 0.765-0.920 (SFQ-total), 0.766-0.877 (SFQ-s), and 0.628-0.899 (SFQ-l). The SFQ proved to be sensitive to detect differences based on age, sex, education level, employment status and preoperative pain intensity. DISCUSSION The SFQ is a valid and reliable eight-item index of surgical fear consisting of two subscales: fear of the short-term consequences of surgery and fear of the long-term consequences.
Collapse
Affiliation(s)
- Maurice Theunissen
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Madelon L. Peters
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands
| | - Erik G. W. Schouten
- Department of Clinical Psychological Science, Maastricht University, Maastricht, the Netherlands
| | - Audrey A. A. Fiddelers
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Mark G. A. Willemsen
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Patrícia R. Pinto
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's – PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Hans-Fritz Gramke
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marco A. E. Marcus
- Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, the Netherlands
- Department of Anesthesia/ICU, Pain and Palliative Care, Hamad Medical Corporation, Doha, Qatar
| |
Collapse
|
98
|
Assessing preoperative anxiety using a questionnaire and clinical rating: a prospective observational study. Eur J Anaesthesiol 2014; 30:758-63. [PMID: 23787971 DOI: 10.1097/eja.0b013e3283631751] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Preoperative anxiety and need for information can be detected during preoperative consultation via structured and standardised screening by the Amsterdam Preoperative Anxiety and Information Scale (APAIS) questionnaire. OBJECTIVE To identify the prevalence of preoperative anxiety and need for information, with regard to influencing factors such as age, sex, previous operation and grade of surgery, and to examine the level of agreement between patients' self-rating and physicians' ratings. DESIGN Prospective observational study. SETTING Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Germany. PATIENTS Two hundred seventeen patients scheduled for elective surgery. INTERVENTIONS The patients completed questionnaires prior to the interaction with the anaesthesiologist. Physicians were blinded to the patients' ratings and provided their subjective ratings about patients' anxiety and need for information immediately after seeing the patient. MAIN OUTCOME MEASURE Degree of anxiety and need for information, agreement of patients' self-reports and physician's rating. RESULTS 18.9% of patients were classified as 'anxiety cases' (31.8% in women and 10.6% in men). The grade of the intended surgery but no other investigated factor was related to patients' anxiety. Age (older patients) was correlated with information requirement (r = 0.21, P = 0.002). Analysis of agreement showed only weak correlations between patients' self-reports and physicians' ratings, demonstrated in low weighted Kappa-coefficients (0.12 to 0.32). CONCLUSION The APAIS is a useful instrument to assess the level of patients' preoperative anxiety and the need for information. Given the relationship between preoperative anxiety and postoperative outcome, it seems justified to incorporate this approach into the preoperative consultation. TRIAL REGISTRATION German Clinical Trials Register DRKS00003084.
Collapse
|
99
|
Koranyi S, Barth J, Trelle S, Strauss BM, Rosendahl J. Psychological interventions for acute pain after open heart surgery. Cochrane Database Syst Rev 2014:CD009984. [PMID: 24861376 DOI: 10.1002/14651858.cd009984.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery on pain, pain medication, mental distress, mobility, and time to extubation. SEARCH METHODS We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2013, Issue 8), MEDLINE (1946 to September 2013), EMBASE (1980 to September 2013), Web of Science (all years to September 2013), and PsycINFO (all years to September 2013) for eligible studies. We used the 'related articles' and 'cited by' options of eligible studies to identify additional relevant studies. We also checked lists of references of relevant articles and previous reviews. We also searched the ProQuest Dissertations and Theses Full Text Database (all years to September 2013) and contacted the authors of primary studies to identify any unpublished material. SELECTION CRITERIA Randomised controlled trials comparing psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention in adults undergoing open heart surgery. DATA COLLECTION AND ANALYSIS Two review authors (SK and JR) independently assessed trials for eligibility, estimated the risk of bias and extracted all data. We calculated effect sizes for each comparison (Hedges' g) and meta-analysed data using a random-effects model. MAIN RESULTS Nineteen trials were included (2164 participants).No study reported data on the number of participants with pain intensity reduction of at least 50% from baseline. Only one study reported data on the number of participants below 30/100 mm on the Visual Analogue Scale (VAS) in pain intensity. Psychological interventions have no beneficial effects in reducing pain intensity measured with continuous scales in the medium-term interval (g -0.02, 95% CI -0.24 to 0.20, 4 studies, 413 participants, moderate quality evidence) nor in the long-term interval (g 0.12, 95% CI -0.09 to 0.33, 3 studies, 280 participants, low quality evidence).No study reported data on median time to remedication or on number of participants remedicated. Only one study provided data on postoperative analgesic use. Studies reporting data on mental distress in the medium-term interval revealed a small beneficial effect of psychological interventions (g 0.36, 95% CI 0.10 to 0.62, 12 studies, 1144 participants, low quality evidence). Likewise, a small beneficial effect of psychological interventions on mental distress was obtained in the long-term interval (g 0.28, 95% CI 0.05 to 0.51, 11 studies, 1320 participants, low quality evidence). There were no beneficial effects of psychological interventions on mobility in the medium-term interval (g 0.23, 95% CI -0.22 to 0.67, 3 studies, 444 participants, low quality evidence) nor in the long-term interval (g 0.29, 95% CI -0.14 to 0.71, 4 studies, 423 participants, low quality evidence). Only one study reported data on time to extubation. AUTHORS' CONCLUSIONS For the majority of outcomes (two-thirds) we could not perform a meta-analysis since outcomes were not measured, or data were provided by one trial only. Psychological interventions have no beneficial effects on reducing postoperative pain intensity or enhancing mobility. There is low quality evidence that psychological interventions reduce postoperative mental distress. Due to limitations in methodological quality, a small number of studies, and large heterogeneity, we rated the quality of the body of evidence as low. Future trials should measure crucial outcomes (e.g. number of participants with pain intensity reduction of at least 50% from baseline) and should focus to enhance the quality of the body of evidence in general. Altogether, the current evidence does not clearly support the use of psychological interventions to reduce pain in participants undergoing open heart surgery.
Collapse
Affiliation(s)
- Susan Koranyi
- Institute of Psychosocial Medicine and Psychotherapy, University Hospital of Jena, Stoystrasse 3, Jena, Thuringia, Germany, 07743
| | | | | | | | | |
Collapse
|
100
|
Graham D, Becerril-Martinez G. Surgical resilience: a review of resilience biomarkers and surgical recovery. Surgeon 2014; 12:334-44. [PMID: 24742757 DOI: 10.1016/j.surge.2014.03.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Revised: 03/10/2014] [Accepted: 03/12/2014] [Indexed: 12/27/2022]
Abstract
BACKGROUND Two distinct and large bodies of literature exist on resilience that are of potential interest for surgical outcomes. First is the literature on the impact of resilience on surgical recovery and wound-healing. Second is the literature on biomarkers for resilience, which largely focuses on neuropeptide Y (NPY), testosterone and dehydroepiandrosterone (DHEA). Despite this activity, there is a dearth of literature linking these two bodies of research by investigating biomarkers for surgical resilience and its impact on surgical recovery. This paper reviews both bodies of literature within the context of surgical recovery. METHOD Literature searches within Medline and Embase were conducted for studies and previous reviews of resilience biomarkers and for the impact of individual resilience on surgical recovery. Reference lists of the reviews were searched for additional papers. No systematic review is yet possible due to the novelty of the use of resilience biomarkers within a surgical context. RESULTS This is the first review to explore a potential link between resilience biomarkers and surgical recovery. There are a number of biomarkers that correlate with individual resilience levels and resilient individuals exhibit better recovery trajectories following surgery, suggesting a novel use of such biomarkers for the identification of "surgical resilience". CONCLUSION By identifying surgical resilience, there is potential for utilising these biomarkers as prognostic indicators of likely recovery trajectories from surgery, which in turn complement individualised peri-operative management.
Collapse
Affiliation(s)
- David Graham
- Department of Surgery, Concord Repatriation General Hospital, Australia; Faculty of Medicine, University of Sydney, Australia
| | | |
Collapse
|