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Yu L, Yang D, Zhou Q, Yin C, Zhang Q, Li W, Yu J, Wang Q. The Effect of Central Sensitization on Postoperative Neurocognitive Dysfunction in Hospitalized Elderly Patients: A Prospective Cohort Clinical Trial. Exp Aging Res 2024; 50:155-170. [PMID: 38192192 DOI: 10.1080/0361073x.2023.2182093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 02/15/2023] [Indexed: 02/25/2023]
Abstract
OBJECTIVE To investigate whether central sensitization (CS) in elderly patients was a predictive risk factor for postoperative neurocognitive dysfunction (PNCD). METHODS One hundred and thirty-three aged patients undergoing total knee arthroplasty (TKA) who received femoral nerve block and general anesthesia were recruited in this research and prospectively assigned into two groups according to the Central Sensitization Inventory (CSI) score: group C (n = 106, CSI score less than 40) and group CS (n = 27, CSI score higher than 40). Scores of Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Confusion Assessment Method (CAM), Numerical Rating Scale (NRS) and Quality of recovery-40 (QoR-40) questionnaires were assessed. Basic information and clinical records of all participants were also collected. RESULTS PNCD occurred in 24 (22.6%) of patients in group C and 16 (59.3%) in group CS (p < .05). Multivariate logistic regression analysis revealed that patients with CSI score ≥40 before surgery exhibited higher risk of PNCD after adjustment for other risk factors (p < .05). Compared to group C, the pre- and post-operative NRS scores, pain duration, the WOMAC score, and propofol consumptions for anesthesia induction were significantly increased in group CS (p < .05). CONCLUSION Hospitalized elderly patients with clinical symptoms of CS scores may have increased risk of PNCD following TKA.
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Affiliation(s)
- Lili Yu
- Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Dongliang Yang
- Department of General Education Courses, Cangzhou Medical College, Cangzhou, Hebei, China
| | - Qi Zhou
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Chunping Yin
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Qi Zhang
- Department of Anesthesiology, Children's Hospital of Hebei Province Afliated to Hebei Medical University, Shijiazhuang, Hebei, China
| | - Wei Li
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Jiaxu Yu
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
| | - Qiujun Wang
- Department of Anesthesiology, the Third Hospital of Hebei Medical University, Shijiazhuang, Hebei, China
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Ju X, Feng J, Yang J, Ge L, Liu X. Factors influencing the preoperative anxiety in lung cancer patients undergoing video-assisted thoracoscopic surgery: The role of information needs, illness perception and patient trust. J Psychosom Res 2023; 172:111374. [PMID: 37302380 DOI: 10.1016/j.jpsychores.2023.111374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/14/2023] [Accepted: 05/10/2023] [Indexed: 06/13/2023]
Abstract
OBJECTIVES This study aimed to investigate preoperative anxiety in patients with lung cancer scheduled for video-assisted thoracoscopic surgery (VATS) and explore the influence of demographic factors, information needs, illness perception, and patient trust in preoperative anxiety. METHODS This cross-sectional study was conducted at a tertiary referral center in China from August 14 to December 1, 2022. Patients with lung cancer (N = 308) scheduled for VATS were evaluated using the Amsterdam Anxiety and Information Scale (APAIS), Brief Illness Perception Questionnaire (BIPQ), and Wake Forest Physician Trust Scale (WFPTS). Multivariate linear regression was employed to determine the independent predictors of preoperative anxiety. RESULTS The average total APAIS anxiety score was (10.6 ± 4.2). Of the sample, 48.4% reported high preoperative anxiety (APAIS-A: ≥10). Multivariate linear regression analysis showed that preoperative anxiety was higher in women (B = 0.860); and that preoperative length of stay ≥24 h (B = 0.016), more information needs (B = 0.988), more severe illness perceptions (B = 0.101) and more patient trust (B = -0.078) may lead to higher preoperative anxiety levels. CONCLUSIONS Preoperative anxiety is common in patients with lung cancer scheduled for VATS. Therefore, more attention should be paid to women and patients with a preoperative length of stay of ≥24 h. Meeting information needs, transforming positive disease perceptions, and strengthening the doctor-patient trusting relationship are key protective factors for preoperative anxiety.
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Affiliation(s)
- Xinxing Ju
- Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jing Feng
- Department of Thoracic Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Jie Yang
- Department of Day Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Ling Ge
- Department of Day Surgery, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Xiaoxin Liu
- Nursing Department, Shanghai Chest Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China.
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3
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Demirel A, Balkaya AN, Onur T, Karaca Ü, Onur A. The Effect of Health Literacy on Preoperative Anxiety Levels in Patients Undergoing Elective Surgery. Patient Prefer Adherence 2023; 17:1949-1961. [PMID: 37588297 PMCID: PMC10426406 DOI: 10.2147/ppa.s419866] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/22/2023] [Indexed: 08/18/2023] Open
Abstract
Objective This study aimed to determine preoperative anxiety levels, their associated factors, and the relationship between health literacy and preoperative anxiety in adult patients undergoing elective surgery. Materials and Methods This descriptive cross-sectional study was conducted in a tertiary hospital between December 21, 2021, and June 20, 2022, and included 466 adult patients. Participants were administered the demographic data and basic health status form, Health Literacy Scale (HLS), and Beck Anxiety Inventory (BAI). Statistical significance was set at p < 0.05. Results The participants' mean BAI score was low to moderate (9.28±10.85). The total HLS score was 105.89±24.42. For the BAI, a negative correlation was found between the access to information sub-dimensions of the HLS and BAI (p=0.043, r=-0.094). In addition, a negative correlation was detected between patients' age and HLS and its sub-dimensions (p<0.001, respectively [r=-0.188, r=-0.193, r=-0.205, r=-0.161]), and a positive correlation was observed among the HLS sub-dimensions (p<0.001, respectively [r=0.873, r=0.057, r=0.966, r=0.915]). Higher HLS and sub-dimension averages were observed in single, high school, university graduates, and civil servant participants. In addition, higher BAI averages were detected in females, homemakers, urban residents, participants living only with their children, and those with additional diseases (respectively, p<0.001, p<0.001, p=0.007, p=0.0034, p<0.01). Conclusion As the level of health literacy increased, preoperative anxiety levels decreased. Preoperative assessment and education are fundamental to perioperative patient care, particularly in the surgical setting.
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Affiliation(s)
- Asiye Demirel
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Anaesthesiology and Reanimation, Bursa, Turkey
| | - Ayşe Neslihan Balkaya
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Anaesthesiology and Reanimation, Bursa, Turkey
| | - Tuğba Onur
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Anaesthesiology and Reanimation, Bursa, Turkey
| | - Ümran Karaca
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Anaesthesiology and Reanimation, Bursa, Turkey
| | - Anıl Onur
- University of Health Sciences, Bursa Yuksek Ihtisas Training and Research Hospital, Department of Anaesthesiology and Reanimation, Bursa, Turkey
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4
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Assessment of the psycho-emotional state of patients after COVID-19-associated pneumonia in relationship with laboratory indicators. ACTA BIOMEDICA SCIENTIFICA 2023. [DOI: 10.29413/abs.2023-8.1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023] Open
Abstract
The aim. To study peculiarities and association of psychological and laboratory indicators in patients with cardiovascular diseases (CVD) who underwent COVID-19 to clarify the factors affecting the possibility of developing delayed psychological and cardiovascular adverse events.Methods. The study enrolled 350 patients with COVID-19. Group 1 consisted of 92 patients without CVD, Group 2 – of 258 patients with CVD. Indicators of laboratory and psychological parameters were assessed according to the data of psychological questionnaire using GAD-7 (General Anxiety Disorder-7), PHQ-9 (Patient Health Questionnaire-9), PSS (Perceived Stress Scale) screening scales and SF-36. Parameters of complete blood count and biochemical blood tests were measured during hospitalization and three months after discharge from the monohospital.Results. After three months, in the general group of patients, signs of anxiety and depression were detected in more than 30 % of the examined patients, signs of stress – in 10.4 %. In the group with CVD, psycho-emotional disorders were identified in 1/4 of the patients, and severe stress – in 8 % of those included in the study. In addition, it was registered that the indicators of erythrocyte sedimentation rate, fibrinogen, high-sensitivity C-reactive protein (CRP), homocysteine and IL-6 remained at a higher level in the second group.Correlation analysis showed that the psychological component of health is interconnected with the level of neutrophils (p = 0.044) and fibrinogen (p = 0.050); the physical component of health is correlated with the level of erythrocytes (p = 0.030), hemoglobin (p = 0.015), CRP (p = 0.002), creatine phosphokinase (p = 0.036) and glucose (p = 0.017). Regression analysis revealed that in patients with CVD three months after hospitalization, an increased glucose index contributes to deterioration, and increased hematocrit and mean hemoglobin concentration improve the quality of life of patients.Conclusion. Laboratory markers that maintain the duration of a prolonged vascular reaction, violation of the rheological and metabolic properties of blood, determine the nature of the development of both psychological and cardiovascular complications.
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Sriboonlert J, Munkong W, Rintawut S, Paladkhua S, Suwongsa R, Kirisattayakul W. Cananga odorata Aromatherapy Reduces Anxiety in Unexperienced Patients Hospitalized for Interventional Neuroradiology Procedures: A Randomized Control Trial. J Evid Based Integr Med 2023; 28:2515690X221150527. [PMID: 36659818 PMCID: PMC9871980 DOI: 10.1177/2515690x221150527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
The hospitalization and the unfamiliar experiences of patients in interventional radiology procedures cause a moderate to high levels of anxiety. This study was aimed to evaluate the anxiolytic effect of Cananga odorata essential oil (COE) aromatherapy in unexperienced patients hospitalized for interventional neuroradiology (INR) procedures. Forty-four patients admitted for their first INR procedure were randomly divided into COE and placebo control groups. COE or distilled water was dropped onto 2 pieces of mulberry paper and attached to the participant's gown at the shoulder level overnight. The main outcomes were observed from the morning salivary cortisol levels and salivary alpha-amylase activity after intervention. The Thai version of Spielberger State-Trait Anxiety Inventory (STAI) and the vital signs (blood pressure and heart rate) were also assessed before and after COE intervention as the secondary outcome. The demographic and baseline data of both groups did not show any significant difference. After intervention, COE group had a significantly lower salivary alpha-amylase activity than placebo control group. The post-intervention scores of Trait (STAI-T) and State (STAI-S) anxiety were significantly less than those of baseline in both groups. Interestingly, the COE group had a greater percentage reduction on STAI-T after intervention than placebo control group. No significant difference was observed in other outcomes. In addition, the salivary alpha-amylase activity was weak but showed significant correlation with STAI anxiety scores. This study indicates that COE aromatherapy reduces the saliva alpha amylase activity and STAI-T anxiety in unexperienced patients hospitalized for INR procedures.
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Affiliation(s)
- Jetsada Sriboonlert
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Waranon Munkong
- Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Sunantha Rintawut
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Soodjai Paladkhua
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Ratchalita Suwongsa
- Department of Nursing, Srinagarind Hospital, Faculty of Medicine,
Khon Kaen University, Khon Kaen, Thailand,Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand
| | - Woranan Kirisattayakul
- Department of Radiology, Faculty of Medicine, Khon Kaen University,
Khon Kaen, Thailand,Woranan Kirisattayakul, Department of
Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, 40002,
Thailand.
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Chen YYK, Soens MA, Kovacheva VP. Less stress, better success: a scoping review on the effects of anxiety on anesthetic and analgesic consumption. J Anesth 2022; 36:532-553. [PMID: 35779126 DOI: 10.1007/s00540-022-03081-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 05/26/2022] [Indexed: 11/29/2022]
Abstract
Preoperative anxiety has an incidence of 11-80% in patients undergoing surgical or interventional procedures. Understanding the role of preoperative anxiety on intraoperative anesthetic requirements and postoperative analgesic consumption would allow personalized anesthesia care. Over- or under-anesthetizing patients can lead to complications such as postoperative cognitive dysfunction in elderly patients, or procedural discomfort, respectively. Our scoping review focuses on the current evidence regarding the association between preoperative anxiety and intraoperative anesthetic and/or postoperative analgesic consumption in patients undergoing elective surgical or interventional procedures. Based on 44 studies that met the inclusion criteria, we found that preoperative anxiety has a significant positive correlation effect on intraoperative propofol and postoperative opioid consumption. The analysis of the literature is limited by the heterogeneity of preoperative anxiety tools used, study designs, data analyses, and outcomes. The use of shorter, validated preoperative anxiety assessment tools may help optimize the intraoperative anesthetic and postoperative analgesic regimen. Further research to determine the most feasible and clinically relevant preoperative anxiety tool and subsequent implementation has the potential to optimize perioperative care and improve patient outcomes.
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Affiliation(s)
- Yun-Yun K Chen
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America
| | - Mieke A Soens
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America
| | - Vesela P Kovacheva
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America.
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7
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Jovanovic K, Kalezic N, Sipetic Grujicic S, Zivaljevic V, Jovanovic M, Kukic B, Trailovic R, Zlatanovic P, Mutavdzic P, Tomic I, Ilic N, Davidovic L. Preoperative Anxiety is Associated With Postoperative Complications in Vascular Surgery: A Cross-Sectional Study. World J Surg 2022; 46:1987-1996. [PMID: 35507076 DOI: 10.1007/s00268-022-06575-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Preoperative anxiety is associated with increased morbidity and/or mortality in surgical patients. This study investigated the incidence, predictors, and association of preoperative anxiety with postoperative complications in vascular surgery. METHODS Consecutive patients undergoing aortic, carotid, and peripheral artery surgery, under general and regional anesthesia, from February until October 2019 were included in a cross-sectional study. Anesthesiologists assessed preoperative anxiety using a validated Serbian version of the Amsterdam Preoperative Anxiety and Information Scale. Patients were divided into groups with low/high anxiety, both anesthesia- and surgery-related. Statistical analysis included multivariate linear logistic regression and point-biserial correlation. RESULTS Of 402 patients interviewed, 16 were excluded and one patient refused to participate (response rate 99.7%). Out of 385 patients included (age range 39-86 years), 62.3% had previous surgery. High-level anesthesia- and surgery-related anxieties were present in 31.2 and 43.4% of patients, respectively. Independent predictors of high-level anesthesia-related anxiety were having no children (OR = 0.443, 95% CI: 0.239-0.821, p = 0.01), personal bad experiences with anesthesia (OR = 2.294, 95% CI: 1.043-5.045, p = 0.039), and time since diagnosis for ≥ 4 months (OR = 1.634, 95% CI: 1.023-5.983, p = 0.04). The female sex independently predicted high-level surgery-related preoperative anxiety (OR = 2.387, 95% CI: 1.432-3.979, p = 0.001). High-level anesthesia-related anxiety correlated with postoperative mental disorders (rpb = 0.193, p = 0.001) and pulmonary complications (rpb = 0.104, p = 0.042). Postoperative nausea (rpb = 0.111, p = 0.03) and postoperative mental disorders (rpb = 0.160, p = 0.002) correlated with high-level surgery-related preoperative anxiety. CONCLUSIONS Since preoperative anxiety affects the postoperative course and almost every third patient experiences anxiety preoperatively, routine screening might be recommended in vascular surgery.
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Affiliation(s)
- Ksenija Jovanovic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia. .,Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Nevena Kalezic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Vladan Zivaljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Center for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan Jovanovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Center for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Biljana Kukic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia
| | - Ranko Trailovic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Zlatanovic
- Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Perica Mutavdzic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ivan Tomic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Lazar Davidovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
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8
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Yu J, Zhang Y, Yu T, Mi W, Yao S, Wang Z, Xu L, Huang Y. Preoperative Anxiety in Chinese Adult Patients Undergoing Elective Surgeries: A Multicenter Cross-Sectional Study. World J Surg 2022; 46:2927-2938. [PMID: 36070012 PMCID: PMC9636076 DOI: 10.1007/s00268-022-06720-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Preoperative anxiety is associated with increased use of anesthetics and poorer postoperative outcomes. However, the prevalence of preoperative anxiety has not been characterized in Chinese patients. In this study, we aimed to estimate the overall prevalence of preoperative anxiety in Chinese adult patients and to explore the sociodemographic and clinical factors associated with preoperative anxiety in China. METHODS This study was a multicenter cross-sectional study conducted at 32 tertiary referral centers in China from September 1 to October 31, 2020. Adult patients scheduled for elective surgery were evaluated by the 7-item Perioperative Anxiety Scale (PAS-7) for preoperative anxiety after entrance to the operating zone. RESULTS A total of 5191 patients were recruited, and 5018 of them were analyzed. The prevalence of preoperative anxiety measured by PAS-7 was 15.8% (95% CI 14.8 to 16.9%). Multivariable analyses showed female sex, younger age, non-retired, first in a lifetime surgery, surgery of higher risk, and poorer preoperative sleep were associated with higher prevalence of preoperative anxiety. CONCLUSIONS Preoperative anxiety was relatively common (prevalence of 15.8%) among adult Chinese patients undergoing elective surgeries. Further studies are needed using suitable assessment tools to better characterize preoperative anxiety, and additional focus should be placed on perioperative education and intervention, especially in primary hospitals. TRIAL REGISTRATION This study was registered prospectively at www.chictr.org.cn (ChiCTR1900027639) on November 22, 2019.
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Affiliation(s)
- Jiawen Yu
- Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Yuelun Zhang
- Medical Research Center, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Tian Yu
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Weidong Mi
- Anesthesia and Operation Center, Chinese PLA General Hospital, Beijing, China
| | - Shanglong Yao
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Xu
- Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 China
| | - Yuguang Huang
- Department of Anesthesiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730 China
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Chen L, Lu K, Luo T, Liang H, Gui Y, Jin S. Observer's Assessment of Alertness/Sedation-based titration reduces propofol consumption and incidence of hypotension during general anesthesia induction: A randomized controlled trial. Sci Prog 2021; 104:368504211052354. [PMID: 34825617 PMCID: PMC10360076 DOI: 10.1177/00368504211052354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Administration of a single propofol bolus dose for anesthesia induction causes hypotension. We included 160 patients (74 males and 86 females; mean age, 42.4 ± 10.7 [range: 18-60] years) with the American Society of Anesthesiologists status I-II undergoing elective surgery under general anesthesia. Using simple randomization, the patients were divided into a conventional group (n = 80; received 2 mg/kg propofol at a rate of 250 mg/min) and titrated group (n = 80; received propofol at a rate of 1 mg/kg/min until the Observer's Assessment of Alertness/Sedation scale score reached 1 point). Fentanyl (4 µg/kg) and cisatracurium (0.2 mg/kg) were administered, as appropriate. Systolic blood pressure, diastolic blood pressure, mean blood pressure, and heart rate were recorded at different time points. Propofol consumption, hypotension, and other adverse events were recorded. All the patients were intubated without awareness. Compared with the conventional group, the titrated group showed more stable blood pressure (p < 0.05), as well as a lower decrease in systolic blood pressure, mean blood pressure at 1 and 3 min, and diastolic blood pressure at 1 min after propofol administration (p < 0.01). Moreover, compared with the conventional group, the titrated group showed a lower post-intubation hypotension incidence (9 vs. 19 cases; p = 0.04), as well as lower total propofol dosage and propofol dose per kilogram of body weight (93.57 ± 14.40 mg vs. 116.80 ± 22.37 mg and 1.73 ± 0.27 mg/kg vs. 2.02 ± 0.08 mg/kg, respectively, p < 0.01). Compared with conventional propofol usage, titrated propofol administration can reduce the incidence of hypotension and propofol consumption during anesthesia induction.
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Affiliation(s)
- Lihong Chen
- Department of Anesthesiology, the Sixth Affiliated
Hospital, Sun Yat-sen University, Guangzhou, China
| | - Kun Lu
- Department of Anesthesiology, the Sixth Affiliated
Hospital, Sun Yat-sen University, Guangzhou, China
| | - Tongfeng Luo
- Department of Anesthesiology, the Sixth Affiliated
Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huiming Liang
- Department of Anesthesiology, the Sixth Affiliated
Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuqin Gui
- Department of Anesthesiology, the Sixth Affiliated
Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sanqing Jin
- Department of Anesthesiology, the Sixth Affiliated
Hospital, Sun Yat-sen University, Guangzhou, China
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10
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Li XR, Zhang WH, Williams JP, Li T, Yuan JH, Du Y, Liu JD, Wu Z, Xiao ZY, Zhang R, Liu GK, Zheng GR, Zhang DY, Ma H, Guo QL, An JX. A multicenter survey of perioperative anxiety in China: Pre- and postoperative associations. J Psychosom Res 2021; 147:110528. [PMID: 34034140 DOI: 10.1016/j.jpsychores.2021.110528] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 05/17/2021] [Accepted: 05/17/2021] [Indexed: 01/09/2023]
Abstract
OBJECTIVES To describe patient characteristics associated with preoperative anxiety and subsequently assess the relationship between preoperative anxiety and postoperative anxiety, pain, sleep quality, nausea and vomiting. METHODS The study collected data from patients undergoing elective operation from 12 hospitals in China. The State-Trait Anxiety Inventory (STAI) and the Athens Insomnia Scale (AIS) were used to assess anxiety and sleep quality before surgery. Evaluations of anxiety, pain, sleep quality, nausea and vomiting were quantified using the Visual Analogue Scale on postoperative days 1 and 2. RESULTS Data from 997 patients were analyzed. Preoperatively, 258 (25.9%) patients had high anxiety (STAI-State>44). Multivariate analyses showed a significant relationship between high anxiety and female gender (OR: 1.66, 95% CI: 1.08-2.57, p = 0.02), highly invasive surgery (OR: 2.29, 95% CI: 1.29-4.06, p = 0.005), higher trait anxiety (OR: 1.24, 95% CI: 1.20-1.28, p < 0.001) and insomnia (AIS ≥ 6, OR: 1.79, 95% CI: 1.17-2.76, p = 0.008). Preoperative anxiety demonstrated a negative correlation with postoperative anxiety following highly invasive surgery; this became a positive relationship following less invasive surgery. Preoperative anxiety was also positively related to postoperative pain and poor sleep quality. The correlation between preoperative anxiety and postoperative nausea and vomiting was not statistically significant. CONCLUSION Female gender, highly invasive surgery, higher trait anxiety and insomnia are independent risk factors for high preoperative anxiety. Surgical invasiveness influences association between pre- and postoperative anxiety. Higher preoperative anxiety is related to poorer sleep quality and more severe pain postoperatively.
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Affiliation(s)
- Xi-Rong Li
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China; School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China
| | - Wen-Hao Zhang
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China
| | - John P Williams
- Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Tong Li
- Department of Pain, Lanzhou Maternity and Child Healthcare Hospital, Lanzhou, Gansu, China
| | - Jian-Hu Yuan
- Department of Anesthesiology, Beijing Rectum Hospital, Beijing, China
| | - Yun Du
- Department of Anesthesiology, University of Chinese Academy of Sciences Affiliated Chongqing Hospital, Chongqing, China
| | - Jin-De Liu
- Department of Anesthesiology, University of Chinese Academy of Sciences Affiliated North China Hospital, Renqiu, Hebei, China
| | - Zhe Wu
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China
| | - Zhao-Yang Xiao
- Department of Anesthesiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Rui Zhang
- School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China
| | - Guo-Kai Liu
- Department of Anesthesiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Guan-Rong Zheng
- Department of Anesthesiology, Shengli Oilfield Central Hospital, Dongying, Shangdong, China
| | - Dong-Ya Zhang
- Department of Anesthesiology, Beijing Huaxin Hospital, The First Affiliated Hospital of Tsinghua University, Beijing, China
| | - Hong Ma
- Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Qu-Lian Guo
- Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jian-Xiong An
- Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China; School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China.
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11
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Huang YL, Xu N, Huang ST, Wang ZC, Cao H, Yu XR, Chen Q. Impact of Music Therapy on Preoperative Anxiety and Degree of Cooperation With Anesthesia Induction in Children With Simple Congenital Heart Disease. J Perianesth Nurs 2021; 36:243-246. [PMID: 33653616 DOI: 10.1016/j.jopan.2020.08.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 07/22/2020] [Accepted: 08/15/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the impact of music therapy (MT) on preoperative anxiety and degree of cooperation with anesthesia induction in children with simple congenital heart disease (CHD). DESIGN A randomized controlled clinical study. METHODS Ninety children were randomly assigned to the MT and control groups. The MT groups underwent a preoperative 30-minute session of MT, whereas the control group did not listen to any music and had the same amount of quiet time. The modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) was used to evaluate the patients' preoperative anxiety on entering the anesthesia waiting area (T1), 10 minutes after entering the waiting area (T2), and during the initiation of anesthesia induction (T3); the degree of cooperation with anesthesia induction was assessed using the Induction Compliance Checklist. The mean arterial blood pressure (MAP) and heart rate (HR) at T1, T2, T3, and T4 (the time of successful anesthesia) were also recorded. FINDINGS One child was excluded from the MT group, and one was excluded from the control group. No difference was found in the mYPAS-SF score, MAP, or HR between the two groups at T1. The mYPAS-SF scores of the MT group were significantly lower than those of the control group at T2 and T3. At T2, T3, and T4, the MAP and HR of the MT group were lower than those of the control group. A statistically significant difference was found in the Induction Compliance Checklist score between the two groups. CONCLUSIONS MT can reduce preoperative anxiety and improve the degree of cooperation with anesthesia induction.
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Affiliation(s)
- Ya-Li Huang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Ning Xu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China; Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Shu-Ting Huang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China; Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Zeng-Chun Wang
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China; Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China
| | - Hua Cao
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Xian-Rong Yu
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Qiang Chen
- Department of Cardiac Surgery, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Women and Children's Critical Diseases Research, Fujian Maternity and Child Health Hospital, Fuzhou, China; Department of Cardiovascular Surgery, Union Hospital, Fujian Medical University, Fuzhou, China.
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