The effect of intraoperative sounds of saw and hammer on psychological condition in patients with total knee arthroplasty: prospective randomized study

Local Anesthesia and Conscious Sedation Does Not Affect Patient's Mood and Anxiety Levels during Percutaneous Endoscopic Lumbar Diskectomy: A Prospective Study

BACKGROUND AND STUDY AIMS

 Undergoing a surgical procedure can be very stressful for patients and can lead to high anxiety levels during both the preoperative and the postoperative period. Levels of anxiety and fear may depend on multiple factors including the type of anesthesia to be used. The objective of this study is to evaluate whether patient's awareness of the surgical environment in the operating room under local anesthesia and conscious sedation (LACS) affects their mood and anxiety levels.

METHODS

 We performed a prospective study for a series of consecutive patients who underwent transforaminal percutaneous endoscopic lumbar diskectomy (PELD) for the treatment of lumbar disk herniation. The patients completed Profile of Mood States (POMS) and State-Trait Anxiety Inventory (STAI) forms in the preoperative period and in the early postoperative period. We divided the patients into two groups according to the type of anesthesia applied during surgery: LACS and general anesthesia (GA) groups. We compared the preoperative and postoperative POMS and STAI scores between groups and the change of these scores between the preoperative and postoperative periods in each group.

RESULTS

 In this study, we included 30 patients who underwent PELD between May and December 2019 and met the inclusion criteria. The GA group consisted of 16 patients and the LACS group consisted of 14 patients. In each group, POMS and STAI scores decreased in the early postoperative period compared with the preoperative period. We found no significant difference in percentage of POMS and STAI TX-1 score changes between the LACS and GA groups.

CONCLUSION

 The results of our study show that patients' awareness of the surgical environment in the operating room under LACS does not significantly affect their mood and anxiety levels and patients do not seem to endure increased emotional stress during the PELD operation, as compared with PELD operation under GA.

A qualitative study of the operating room experience of patients who underwent surgery under spinal anesthesia: "It was like an adventure"

This study aimed to explore the experiences of the people who underwent orthopedic surgery under spinal anesthesia and to report their feelings and thoughts. The study was carried out using a qualitative approach. Twenty-one patients were interviewed who underwent orthopedic surgery on the first or second postoperative day. Content analysis was performed after the collection of raw data. NVIVO 12 Pro software was used for data analysis. The frequency count (f) and participant codes (P) were used for the presentation of the findings. The themes and frequency counts obtained by analyzing the interviews with the patients were as follows: "Time passed like watching a movie" (f = 213), "Like an adventure" (f = 587), and "See, feel, look" (f = 405). Five of 21 participants (23.8%) stated that they would not recommend spinal anesthesia. The findings generally indicated the anxiety caused by the unknown, fear in the preanesthetic period, operation experienced like an adventure, and a process generally completed with satisfaction.

A systematic review of the use of music interventions to improve outcomes for patients undergoing hip or knee surgery

AIM

To examine the effectiveness of music as an adjunct treatment for pain, anxiety, and/or postoperative delirium, for patients undergoing hip or knee surgery.

BACKGROUND

Patients undergoing hip or knee surgery are known to experience pain and anxiety before and after surgery and be prone to postoperative delirium.

DESIGN

Quantitative systematic review.

DATA SOURCES

CENTRAL, Embase, Ovid MEDLINE, CINAHL, and PsycINFO databases were systematically searched without time limits (to June 2018).

REVIEW METHODS

A systematic search yielded 10 randomized controlled trials and quasi-experimental designs. Studies were appraised using the Cochrane Risk of Bias Tool. Data were extracted using the Effective Practice and Organization of Care data extraction tool.

RESULTS

Mixed results were found for the effect of music on anxiety, pain, and postoperative delirium in patients undergoing hip or knee surgery. Six of 10 included studies provided evidence that music can improve anxiety, pain, or postoperative delirium outcomes for patients undergoing hip or knee surgery. Music effectively reduced anxiety in one of three studies. Three of seven studies reported benefits of music for reducing postoperative pain. Positive effects of music on postoperative delirium were reported in all three studies that evaluated this outcome. Within group improvements were observed in many of the studies.

CONCLUSION

Music has the potential to improve outcomes of anxiety, pain, and postoperative delirium, for patients undergoing hip or knee surgery. The low number of studies found indicates results should be treated with caution. Further studies are required to provide strong evidence generalizable to a broader population.