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Yılmaz Y, Durmayuksel E, Erturk T, Inal FY, Yamac DM, Ersoy A. The Effect of Preoperative Anxiety on Motor and Sensory Block Duration and Effectiveness in Spinal Anesthesia. Anesthesiol Res Pract 2024; 2024:8827780. [PMID: 39188895 PMCID: PMC11347032 DOI: 10.1155/2024/8827780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 07/19/2024] [Accepted: 08/06/2024] [Indexed: 08/28/2024] Open
Abstract
Introduction The aim was to evaluate the effect of preoperative anxiety on the sympathetic block that developed after spinal anesthesia and therefore the duration of motor and sensory blockade. Materials and Methods After the approval of the ethics committee, 90 patients between the ages of 18 and 55 years who were to be operated under spinal anesthesia were included in the study. Preoperative anxiety of the patients was evaluated with the Spielberger trait and State Anxiety Scale and Visual Analog Scale (VAS). The Bromage scores of the patients were followed up intermittently. Onset time of sensory block, onset time of motor block, and motor block recovery time were recorded. Cases with bradycardia and hypotension were noted. Results No statistically significant correlation was found between the duration of motor block onset (5.81 ± 4 min), the sensory block onset time (0.89 ± 0.4 min), and the motor block recovery time (92.06 ± 36.9 min) with other variables. VAS (5.81 ± 2.5), STAI-1 (40.4 ± 9.8), and STAI-2 (41.69 ± 8.2) values had a statistically significant effect on the occurrence of bradycardia (14.4%). The variables of VAS, STAI-1, STAI-2, sensory block onset, motor block onset, and motor block recovery time were statistically significantly higher in women (mean 5.24 ± 2.4, 38.97 ± 9.9, 41.43 ± 8.7, 0.89 ± 0.42, 5.64 ± 3.82, and 88.77 ± 38.74 in males and mean 7.15 ± 2.1, 43.74 ± 8.9, 42.30 ± 7.0, 0.88 ± 0.27, 6.20 ± 4.35, and 99.70 ± 31.70 in females, respectively). Conclusion It was observed that preoperative anxiety had no effect on motor and sensory block onset and duration.
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Affiliation(s)
- Yadigar Yılmaz
- Sultan 2. Abdulhamid Han Education and Research HospitalDepartment of Anesthesiology and Reanimation, Istanbul 34668, Türkiye
| | - Esra Durmayuksel
- Bahçeşehir UniversityFaculty of Health SciencesNursing Department, Istanbul, Türkiye
| | - Tuna Erturk
- Sultan 2. Abdulhamid Han Education and Research HospitalDepartment of Anesthesiology and Reanimation, Istanbul 34668, Türkiye
| | - Ferda Yılmaz Inal
- Istanbul Medeniyet UniversityFaculty of MedicineDepartment of Anesthesiology and Reanimation 34722, Istanbul, Türkiye
| | - Dilek Metin Yamac
- Sultan 2. Abdulhamid Han Education and Research HospitalDepartment of Anesthesiology and Reanimation, Istanbul 34668, Türkiye
| | - Aysin Ersoy
- Sultan 2. Abdulhamid Han Education and Research HospitalDepartment of Anesthesiology and Reanimation, Istanbul 34668, Türkiye
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Rtbey G, Mihertabe M, Andualem F, Melkam M, Takelle GM, Tinsae T, Fentahun S. Anxiety and associated factors among medical and surgical patients in Ethiopia: A systematic review and meta-analysis. PLoS One 2024; 19:e0306413. [PMID: 39046996 PMCID: PMC11268606 DOI: 10.1371/journal.pone.0306413] [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: 12/07/2023] [Accepted: 06/12/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Individuals diagnosed with chronic medical conditions and patients appointed to undergo surgery face various degrees of anxiety as a result of doubts related to the outcome of surgery, and the psycho-socioeconomic costs of the medical illness. This can affect the treatment process and even the outcome of patients with medical and surgical cases. Though different studies were conducted on anxiety and associated factors among medical and surgical patients in Ethiopia, the findings were found to be inconsistent and had a wide discrepancy. So, this systematic review and meta-analysis estimated the pooled effect size of anxiety among this population and guides to plan appropriate intervention at a national level. METHODS Studies conducted on anxiety and associated factors among medical and surgical patients in Ethiopia were included. Data was extracted using Microsoft Excel and analyzed using STATA version 11. The random-effects model was used to estimate the pooled effect size of anxiety and its determinants with 95% confidence intervals. Funnel plots and Egger's regression tests were employed to check publication bias. Sub-group and sensitivity analyses were also conducted. RESULTS The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be 48.82% with a 95% CI (42.66, 54.99). Being female[OR = 2.84(2.02, 4.01)], fear of death [OR = 2.93(1.57, 5.50)], and history of surgery[OR = 0.42(0.27, 0.065)], among surgical patients and being female[OR = 2.35(1.94, 2.850], having poor social support[OR = 2.22(1.62, 3.05)], perceived stigma[OR = 4.25(1.97, 9.18)] and family history of mental illness[OR = 1.86(1.21, 2.86)] among medical patients were significantly associated with anxiety in this systematic review and meta-analysis. CONCLUSION AND RECOMMENDATION The pooled prevalence of anxiety among medical and surgical patients in Ethiopia was found to be high. Therefore, it would be good for professionals to screen patients for anxiety besides managing their medical or surgical cases to detect them early and address them.
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Affiliation(s)
- Gidey Rtbey
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Milen Mihertabe
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Fantahun Andualem
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mamaru Melkam
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Girmaw Medfu Takelle
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Techilo Tinsae
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Setegn Fentahun
- Department of Psychiatry, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Alsufyani F, Katooa N, Al-Zahrani A, Felemban O, Badr H, Thabet H. The Impact of Educational Sessions on Anxiety Levels among Women Undergoing Caesarean Section: A Quasi-Experimental Study. Eur J Investig Health Psychol Educ 2024; 14:324-338. [PMID: 38391489 PMCID: PMC10887552 DOI: 10.3390/ejihpe14020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/11/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Although the Caesarean section (CS) is considered a harmless surgery, it has various complications. Women scheduled for elective CSs often have high levels of anxiety due to a lack of knowledge. The aim of this quantitative quasi-experimental study was to determine the relationship between preoperative educational sessions and anxiety levels among women undergoing CSs. The study was conducted at the antenatal unit in the King Faisal Medical Complex (KFMC) in Taif, Saudi Arabia, using a structured interview questionnaire, the State-Trait Anxiety Inventory (STAI), and satisfaction interviews. A total of 50 pregnant women participated in this study, who were divided into two groups: 25 participants in the intervention group and 25 in the control group. Most participants (92%) in the intervention group had low anxiety levels following educational sessions, and 96% of the participants were very satisfied with the preoperative information they had been given. Women in the control group (again, 92%) had high anxiety levels, and there was a significant difference in the anxiety levels of the intervention and control groups (p ≤ 0.5) after the educational sessions. Providing proper preoperative education about CSs can reduce preoperative anxiety, improve patient outcomes, and enhance patients' involvement in their care and decision-making.
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Affiliation(s)
| | - Nouran Katooa
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ahlam Al-Zahrani
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Ohood Felemban
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hanan Badr
- Faculty of Nursing, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Hala Thabet
- Faculty of Nursing, Mansoura University, Mansoura 35516, Egypt
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Aldobekhi FSS, Almutairi MM, Alanazi MH, Aldawsari BM, Almutairi SS, Alenazi AK, Binmuhareb AN, Alfadhil GA, Alaoufi SY, Alqahtani AO. Apprehension of Paraplegia after Undergoing Spinal Anesthesia in the Central Region Population of Saudi Arabia: A Cross-Sectional Study. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2024; 16:S530-S533. [PMID: 38595625 PMCID: PMC11000943 DOI: 10.4103/jpbs.jpbs_847_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/12/2023] [Accepted: 09/17/2023] [Indexed: 04/11/2024] Open
Abstract
Aim The aim of the present study was to determine the prevalence of paraplegia-related fear in spinal anesthesia among the general population in the central region of Saudi Arabia. Materials and Methods A total of 371 participants were given a pretested, precoded, questionnaire was used to collect data to assess the prevalence of fear of paraplegia in spinal anesthesia. The questionnaire contained questions to assess variables like the extent of fear, causes, gender preponderance, any false information about paraplegia in spinal anesthesia, and complications experienced after receiving spinal anesthesia. Results It was noted that 80.1% of the respondents were familiar with the term spinal/regional/epidural anesthesia. Forty one point eight percent of the respondents their reference of knowledge about regional anesthesia was family of friends. Thirteen point nine percent of the responses were paralysis, 8.2% of the responses were feeling of pain during the operation, and 7.9% of the responses were nausea or vomiting. Conclusion The present study revealed that the participants exhibited a certain degree of apprehension stemming from their inadequate understanding and awareness regarding spinal anesthesia.
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Affiliation(s)
| | - Manal M. Almutairi
- Medical Intern, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Mohammed H. Alanazi
- Medical Intern, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Badah M. Aldawsari
- Medical Intern, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Sarah S. Almutairi
- Medical Intern, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | | | | | - Ghadi A. Alfadhil
- Medical Intern, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
| | - Shouq Y. Alaoufi
- Medical Intern, College of Medicine, Majmaah University, Majmaah, Saudi Arabia
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Jiang A, Perry T, Walker K, Burfoot A, Patterson L. Surgical sensation during caesarean section: a qualitative analysis. Int J Obstet Anesth 2024; 57:103935. [PMID: 37925355 DOI: 10.1016/j.ijoa.2023.103935] [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: 11/24/2022] [Revised: 08/13/2023] [Accepted: 10/02/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Caesarean section (CS) is a major abdominal surgery performed usually on a young and healthy population under neuraxial anesthesia with little to no sedation. This creates a distinct surgical experience whereby patients are aware of the surgical process, physical sensations, and their environment. This study aimed to provide an in-depth descriptive assessment of subjective surgical experience during CS under regional anaesthesia. We expected the information gained would enhance our current understanding and better alleviate patient anxiety through informed counselling. METHODS This qualitative descriptive study was conducted at a Canadian academic centre. Twenty patients participated in semi-structured interviews within a week of CS, using an interview guide developed for this study. Patient medical records were reviewed to collect demographic and surgical information. Thematic analysis was conducted using an inductive approach to determine common themes. RESULTS Nine themes were identified. Five themes were identified in the category of surgical sensation and four themes were identified in the category of peri-operative education. CONCLUSIONS Patients commonly experienced pressure and movement sensations at varying intensity, and most did not experience pain. Environmental factors, including sounds and distraction by the newborn, affected perception of surgical sensation. Patients wish to receive pre-operative counselling regarding potential surgical sensations, as well as ongoing communication from their anaesthesiologist. These results can be used to guide informed discussions with patients and direct further investigation in this area.
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Affiliation(s)
- A Jiang
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada.
| | - T Perry
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada
| | - K Walker
- Department of Sociology, Queen's University, Kingston, Ontario, Canada
| | - A Burfoot
- Department of Sociology, Queen's University, Kingston, Ontario, Canada
| | - L Patterson
- Department of Anesthesiology and Perioperative Medicine, Kingston Health Sciences Centre, Kingston, Ontario, Canada
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Dibabu AM, Ketema TG, Beyene MM, Belachew DZ, Abocherugn HG, Mohammed AS. Preoperative anxiety and associated factors among women admitted for elective obstetric and gynecologic surgery in public hospitals, Southern Ethiopia: a cross-sectional study. BMC Psychiatry 2023; 23:728. [PMID: 37807071 PMCID: PMC10561508 DOI: 10.1186/s12888-023-05005-2] [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: 03/06/2023] [Accepted: 07/05/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND Preoperative anxiety is a major mental health problem during the preoperative period. Admission of women to surgery is stressful, and a high level of anxiety was associated with increased perioperative morbidity and mortality, poor treatment satisfaction, and bad obstetric outcomes, including long-term cognitive impairment in children. Despite its negative consequences, little is known on this area, particularly in the study area. OBJECTIVE To assess preoperative anxiety and associated factors among women admitted for elective obstetrics and gynecologic surgeries in public hospitals in Southern Ethiopia, 2022. METHODS AND MATERIALS An institution-based cross-sectional study design was conducted among 389 women using structured interviewer-administered samples who were selected by systematic random sampling from May 20th to June 20th, 2022. The Amsterdam preoperative anxiety and information scale (APAIS) was used to assess the level of anxiety. Data were collected electronically using the Open Data Kit version 2022.2.3 and analyzed with the Statistical Package for Social Sciences version 26.0. Bivariate and multivariable logistic regression analyses were done. The strength of the association was declared by using an adjusted odds ratio (AOR) with a 95% confidence interval, and a statistical significance of P < 0.05. RESULTS The magnitude of preoperative anxiety was 57.1% (95% CI = 51.4-61.5), and 48.1% of women required an average amount of information. Being a gynecologic patient (AOR = 2.0, 95% CI = 1.21, 3.32), having previous anesthesia and surgery (AOR = 2.09, 95% CI = 1.10, 3.96), having fear of postoperative pain (AOR = 1.96, 95% CI = 1.08, 3.53), having concern for family (AOR = 2.56, 95% CI = 1.49, 4.37), having poor social support (AOR = 3.75, 95% CI = 1.99, 7.09), and moderate social supports (AOR = 3.27, 95% CI = 1.74, 6.17), and having a high information requirement about anesthesia and surgery (AOR = 4.68, 95%CI = 2.16, 10.13) were statistically associated with preoperative anxiety. CONCLUSION Preoperative anxiety was often high in the region. Associated factors were the type of surgery, previous anesthesia and surgery, fear of postoperative pain, fear for family, social support, and a high information need. So the national and regional health bureau should develop guidelines and implement strategies to reduce women preoperative anxiety as part of midwifery care. The women should be assessed regularly during the preoperative visits; and appropriate anxiety reduction and information regarding surgery, and anesthesia should be provided.
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Affiliation(s)
- Abera Mamo Dibabu
- Department of Midwifery, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia.
| | - Teklemariam Gultie Ketema
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Maechel Maile Beyene
- Department of Midwifery, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Dereje Zeleke Belachew
- Department of Midwifery, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
| | | | - Abdu Seid Mohammed
- Department of Midwifery, College of Medicine and Health Sciences, Mizan Tepi University, Mizan Teferi, Ethiopia
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Topal Hançer A. Prevalence and factors associated with surgery anxiety in hospitalized patients: a point-prevalence study. Ir J Med Sci 2023; 192:2095-2103. [PMID: 37548838 DOI: 10.1007/s11845-023-03475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 07/24/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Preoperative anxiety is a challenging problem in the preoperative care of patients. Identifying risk factors helps nurses provide psychological support during the pre-operative visit so that stress can be reduced. AIMS This study aimed to determine the prevalence of surgical anxiety and related factors in hospitalized surgical patients. METHODS This research was designed as a point-prevalence study. The study was completed with 223 patients hospitalized in the surgical clinics of a tertiary hospital in Turkey. Surgical anxiety questionnaire (SAQ) and State-trait anxiety inventory (STAI) were used for the assessment of anxiety. RESULTS Preoperative anxiety prevalence was 69.5% according to the SAQ and 49.3% according to STAI. Women, participants with no primary school education, those who were unemployed and had low income, those with no previous surgery, those living in fear of surgery, the participants who underwent major surgery and general anesthesia, and those who did not have knowledge about the surgical procedure and anesthesia had higher anxiety according to the two scales. A highly significant and positive correlation was found between total STAI and total SAQ. CONCLUSION The importance of surgical anxiety for the health system, which affects two out of every three hospitalized patients, should not be underestimated. Therefore, national and global plans should be made to prevent and manage surgical anxiety.
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Affiliation(s)
- Ayşe Topal Hançer
- Nursing Department, Faculty of Health Sciences, Sivas Cumhuriyet University, Sivas, Turkey.
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Tawfeeq NA, Hilal F, Alharbi NM, Alowid F, Almaghrabi RY, Alsubhi R, Alharbi SF, Fallatah A, Aloufi LM, Alsaleh NA. The Prevalence of Acceptance Between General Anesthesia and Spinal Anesthesia Among Pregnant Women Undergoing Elective Caesarean Sections in Saudi Arabia. Cureus 2023; 15:e44972. [PMID: 37822429 PMCID: PMC10563372 DOI: 10.7759/cureus.44972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 10/13/2023] Open
Abstract
Background The choice of anesthesia for an elective cesarean section should be based on an individual benefit-risk assessment, considering the pregnant woman's preferences, concerns, and the available medical expertise. This study aimed to determine the preferences for general and spinal anesthesia among women undergoing elective cesarean sections and the factors affecting their choice. Methods The study design is a cross-sectional study, and it was conducted on pregnant women to measure the acceptance of general anesthesia and spinal anesthesia in patients with elective cesarean sections in Saudi Arabia. Random pregnant women were invited to participate in this study across Saudi Arabia after fulfilling the inclusion criteria. A digital questionnaire was distributed across Saudi Arabia to be filled out by female residents. A Microsoft Excel (Microsoft Corporation, Redmond, Washington, USA) sheet was used for data entry, while IBM SPSS software version 27.0.1 (IBM Corp., Armonk, New York, USA) was used for statistical analysis. Results The study included 813 participants; most (28%) of them were 25-30 years old. Of the study participants, 54% had chosen spinal anesthesia before, 22% had chosen general anesthesia, and 24% had chosen neither. Reasons to choose general anesthesia were reported as follows: 21.6% feared pain during surgery, 24.2% feared watching the surgical procedures on their bodies, 16.6% feared back pain, 12.8% feared being paralyzed, and 15.1% feared needles used to administer anesthesia in the lower back. Reasons for choosing spinal anesthesia were reported as follows: 26.3% had back pain concerns; 13% feared prolonged unconsciousness; 9.6% feared having a headache after surgery; 17% had post-surgery pain concerns; 30.1% wanted to be alert at the time of the birth of the baby; 10.6% feared the chances of experiencing nausea and vomiting; and 7.4% feared not being able to breastfeed. Conclusion Spinal anesthesia was chosen by more participants than general anesthesia. There was a statistically significant association between choosing spinal anesthesia and the number of previous pregnancies, parity, history of preterm labor, and recommendation to undergo general or spinal anesthesia by non-medical staff. It was also significant with the older age and higher educational level of participants. This decision may be influenced by a number of variables, the most significant of which are prior experience with general anesthesia or spinal anesthesia, educational attainment, and non-medical advice.
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Affiliation(s)
- Nasser A Tawfeeq
- Department of Anesthesiology, King Abdulaziz Medical City in Riyadh (KAMC-RD), Riyadh, SAU
| | - Faisal Hilal
- Department of Anesthesiology and Pain Management, King Abdullah Medical Complex - Jeddah (KAMCJ), Jeddah, SAU
| | - Noof M Alharbi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Fay Alowid
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Rana Y Almaghrabi
- College of Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Rahaf Alsubhi
- College of Medicine, Qassim University, Buraydah, SAU
| | | | - Amal Fallatah
- College of Medicine, Al-Rayan Colleges, Al Madinah, SAU
| | - Leenah M Aloufi
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU
| | - Noor A Alsaleh
- College of Medicine, King Faisal University, Al-Ahsa, SAU
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Pennington BRT, Politi MC, Abdallah AB, Janda AM, Eshun-Wilsonova I, deBourbon NG, Siderowf L, Klosterman H, Kheterpal S, Avidan MS. A survey of surgical patients' perspectives and preferences towards general anesthesia techniques and shared-decision making. BMC Anesthesiol 2023; 23:277. [PMID: 37592215 PMCID: PMC10433576 DOI: 10.1186/s12871-023-02219-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 07/23/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The decision about which type of general anesthetic to administer is typically made by the clinical team without patient engagement. This study examined patients' preferences, experiences, attitudes, beliefs, perceptions, and perceived social norms about anesthesia and about engaging in the decision regarding general anesthetic choice with their clinician. METHODS We conducted a survey in the United States, sent to a panel of surgical patients through Qualtrics (Qualtrics, Provo, UT) from March 2022 through May 2022. Questions were developed based on the Theory of Planned Behavior and validated measures were used when available. A patient partner who had experienced both intravenous and inhaled anesthesia contributed to the development and refinement of the questions. RESULTS A total of 806 patients who received general anesthesia for an elective procedure in the last five years completed the survey. 43% of respondents preferred a patient-led decision making role and 28% preferred to share decision making with their clinical team, yet only 7.8% reported being engaged in full shared decision making about the anesthesia they received. Intraoperative awareness, pain, nausea, vomiting and quickly returning to work and usual household activities were important to respondents. Waking up in the middle of surgery was the most commonly reported concern, despite this experience being reported only 8% of the time. Most patients (65%) who searched for information about general anesthesia noted that it took a lot of effort to find the information, and 53% agreed to feeling frustrated during the search. CONCLUSIONS Most patients prefer a patient-led or shared decision making process when it comes to their anesthetic care and want to be engaged in the decision. However, only a small percentage of patients reported being fully engaged in the decision. Further studies should inform future shared decision-making tools, informed consent materials, educational materials and framing of anesthetic choices for patients so that they are able to make a choice regarding the anesthetic they receive.
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Affiliation(s)
| | - Mary C Politi
- Department of Surgery, Division of Public Health Sciences, Washington University School of Medicine, St. Louis, MO, USA
| | - Arbi Ben Abdallah
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Allison M Janda
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Lilly Siderowf
- College of Arts and Sciences, Washington University, St. Louis, MO, USA
| | | | - Sachin Kheterpal
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA
| | - Michael S Avidan
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
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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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Asali F, Abu Mahfouz I, Al-Marabhah L, Alatoom S, Al Takriti L, Eisheh ZA, Al Kuran O, Jaber H. Correlates of higher anxiety scores reported by women admitted for elective caesarean section. Heliyon 2023; 9:e18143. [PMID: 37501957 PMCID: PMC10368820 DOI: 10.1016/j.heliyon.2023.e18143] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 06/16/2023] [Accepted: 07/10/2023] [Indexed: 07/29/2023] Open
Abstract
Background An elective caesarean section (CS) has been associated with high anxiety scores, and there are associations between higher anxiety scores and younger age, primigravidae, higher educational level, and previous experience with anaesthesia. In this study, the aim is to measure anxiety scores associated with an elective CS using two measuring scales and identify women's characteristics and obstetrics variables that are associated with higher scores. Methods A cross-sectional study was conducted between Nov 15, 2019 and Nov 15, 2020. Women were included if they were 18 years of age or more, had viable pregnancies, and were admitted for an elective CS. Anxiety scores were measured on admission using the visual analogue scale for anxiety (VASA) and then the State-Trait Anxiety Inventory (STAI-Y). Associated factors were studied using logistic regression analyses. Results Three hundred women were recruited. Means (SD) for the participant's age and gestation age were 30.5 (5.7) years and 37.6 (1.4) weeks, respectively. Additionally, 29.3% of the participants having a CS were primigravidae and 62.3% were for maternal indications. Furthermore, 55%, 59%, and 61% of the women had scores above the means of VASA and STAI-S components 1 and 2, respectively.Variables that showed statistically significant associations with higher anxiety scores were that the woman's age was 25-34, the CS was for foetal indications, the choice of anaesthesia was general, and the source of information for the choice of anaesthesia was a layperson. Conclusion Higher anxiety scores are prevalent among women admitted for an elective CS. STAI-Y and VASA correlated well, and the short VASA may replace the lengthy STAI-Y in clinical practice. Identification of women with risk factors may help in implementing strategies to reduce anxiety.
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Affiliation(s)
- Fida Asali
- FRCOG, Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, Faculty of Medicine, The Hashemite University, Zarqa, Jordan
| | - Ismaiel Abu Mahfouz
- FRCOG, Obstetrics and Gynaecology, Faculty of Medicine, Al Balqa Applied University, Al Salt, Jordan
| | | | - Shirin Alatoom
- JBOG, Obstetrics and Gynaecology, Specialty Hospital, Amman, Jordan
| | - Lana Al Takriti
- JBOG, Obstetrics and Gynaecology, Specialty Hospital, Amman, Jordan
| | | | - Oqba Al Kuran
- FRCOG, Obstetrics and Gynaecology, Faculty of Medicine, The University of Jordan, Amman, Jordan
| | - Hatim Jaber
- Community Medicine, Faculty of Medicine, Al Balqa Applied University, Al Salt, Jordan
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12
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Singh K, Heralal H. The Effect of a Simple Perioperative Video on Maternal Anxiety and Satisfaction Before Regional Anesthesia in a Caribbean Setting: A Randomized Controlled Trial. Cureus 2023; 15:e36482. [PMID: 37090355 PMCID: PMC10118283 DOI: 10.7759/cureus.36482] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/25/2023] Open
Abstract
BACKGROUND Anxiety before regional anesthesia and surgery is common among women undergoing cesarean section. Although perioperative education has been shown to reduce this level of anxiety, the optimal form and timing of this intervention are not known. The goal of this study was to evaluate the efficacy of an educational anesthetic video on reducing anxiety and improving maternal satisfaction in patients scheduled for elective cesarean section under regional anesthesia. METHODS Eighty patients scheduled for cesarean section at a tertiary-level obstetric center were randomized to either an interventional group (viewed an educational video on the evening before surgery) or the control group (no educational video). Both groups received a standard preoperative assessment on the morning of surgery. Anxiety was assessed using the Spielberger State-Trait Anxiety Inventory (STAI) and the visual analog scale for anxiety (VAS-A). Maternal satisfaction was assessed using the Maternal Satisfaction Scale Score for Cesarean Section (MSSSCS). Anxiety was assessed at baseline (the evening before surgery) and immediately before surgery. Maternal satisfaction was assessed on the first postoperative day. Patients in the intervention group also had their state anxiety measured immediately after viewing the educational anesthetic video using the VAS-A. RESULTS Both groups were equally matched at baseline, and a statistically significant reduction in anxiety measured using VAS-A was seen in the intervention group vs. the control group (6 vs. 4.6, p = 0.018). State-trait anxiety measured using STAI, however, was not significantly lower in the intervention vs. control group (44 vs. 46, p = 0.99). VAS-A immediately after looking at the video was also not significantly different (5 vs. 4, p = 0.323) from the control group. Maternal satisfaction was also higher in the intervention group (113 vs. 104.5, p = 0.015). CONCLUSION The use of a simple educational anesthetic video may be associated with reduced anxiety and improved maternal satisfaction in patients scheduled for elective cesarean section under regional anesthesia.
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Affiliation(s)
- Keevan Singh
- Anesthesia and Intensive Care Unit, Department of Clinical and Surgical Sciences, University of the West Indies, San Fernando, TTO
| | - Hema Heralal
- Department of Anesthesia and Intensive Care, Port of Spain General Hospital, Port of Spain, TTO
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Evaluating patients' choice of general and spinal anesthesia for elective cesarean section and associated factors: a descriptive study. Ann Med Surg (Lond) 2023; 85:6-12. [PMID: 36742112 PMCID: PMC9893422 DOI: 10.1097/ms9.0000000000000010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 11/12/2022] [Indexed: 02/07/2023] Open
Abstract
During an elective cesarean section, the choice of method of anesthesia is critical for maternal and fetal outcomes. However, the anesthesiologist's decision is dependent on the patient's desire. This study aimed to determine the choice of general and spinal anesthesia among women undergoing elective cesarean sections and the factors affecting their choice. Methods In this descriptive study, pregnant women who had the ability to undergo both spinal and general anesthesia were referred to public and private hospitals in (Sari Imam Khomeini Hospital, Mazandaran University of Medical Sciences). A questionnaire recorded the patient's demographic data, education and occupation, history of anesthesia, choice of anesthetic method, and reason for selection. Results A total of 384 women were included in the study, of whom 60% selected general anesthesia and 40% selected spinal anesthesia. Among the reasons for not choosing spinal anesthesia, most common were fear of injury to the spinal cord (64.3%) and fear of seeing and hearing during the surgery (53.3%), and among the reasons for not choosing general anesthesia, most common were fear of not waking (54.3%) and a desire to be alert at the time of infant birth (40.7%). Most of the women with a history of spinal anesthesia selected spinal anesthesia (53%), and 62% of those without a history of spinal anesthesia selected general anesthesia. Factors such as age, nonmedical staff advice, and being employed were significantly correlated with the choice of anesthesia (P<0.005). Conclusion The rate of general anesthesia selection was higher than spinal anesthesia. More attention and efforts are required to educate patients regarding the method of anesthesia prior to the surgery.
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Effect of Acupressure Applied After Cesarean Section Under Spinal Anesthesia Postpone the Duration of Taking Analgesics and on The Gastrointestinal System: A Randomized Controlled Trial. Explore (NY) 2023; 19:58-64. [PMID: 35074319 DOI: 10.1016/j.explore.2021.12.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 11/06/2021] [Accepted: 12/31/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Cesarean deliveries are one of the primary conditions associated with postoperative decreased motility of the gastrointestinal system and are characterized by acute pain and distention. The aim of the present study was to investigate the application of acupressure and the administration of analgesics for women who underwent cesarean section under spinal anesthesia could be delayed and how spontaneous gastrointestinal system motility could be achieved in the postoperative period. DESIGN Randomized controlled trial SETTING: Private Medipol Nisa Hospital, Istanbul, Turkey INTERVENTION: This trial was conducted with 112 primipara pregnant women who delivered via cesarean section under spinal anesthesia and were randomly assigned into the acupressure (n=52) and control (n=60) groups. The participants in the acupressure group (n=52) were treated for 20 minutes. The participants in the control group (n=60) were treated per the hospital protocol (analgesics for pain, flatulation and defecation, no pharmacological or non-pharmacological application was performed). RESULTS The time that elapsed for the administration of analgesics was significantly later in the acupressure group than in the control group (p <.001). The first occurrence of flatulation and defecation were significantly earlier in the acupressure group (19 and 23 hours, respectively) than in the control group (34 and 27 hours, respectively) (p <.001). CONCLUSION Acupressure is an easy, non-invasive method that postpones the administration of analgesics in the postoperative period and prevents flatulence and constipation caused by the decreased motility of GIS.
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Effects of Benson Relaxation Technique and Music Therapy on the Anxiety of Primiparous Women Prior to Cesarean Section: A Randomized Controlled Trial. Anesthesiol Res Pract 2022; 2022:9986587. [PMID: 36589598 PMCID: PMC9803568 DOI: 10.1155/2022/9986587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/03/2022] [Accepted: 12/06/2022] [Indexed: 12/25/2022] Open
Abstract
Background and Aims Primiparous women experience high levels of anxiety before cesarean section. Therefore, this research aimed to investigate the effects of the Benson Relaxation Technique (BRT) and Music Therapy (MT) on the anxiety of primiparous women prior to cesarean section. Methods A randomized controlled trial was carried out on 105 women scheduled for cesarean section. They were randomly assigned into three groups: BRT, MT, and control (n = 35 per group). The women in the BRT and MT groups performed exercises and listened to music, respectively, for 20 minutes prior to cesarean section. The State Anxiety Inventory was used to measure the women's anxiety in the groups before and after the intervention. Results Within-group comparisons showed that the women in the BRT (t = 5.61, p < 0.001, effect size (Cohen's d) = 0.94) and MT (t = 3.83, p = 0.001, d = 0.64) groups had significantly lower anxiety after the interventions compared to before the interventions. Also, between-group comparisons revealed that anxiety after the intervention was significantly lower in the BRT and MT groups compared to the control group (p = 0.007). Conclusions Although both of the BRT and MT helped with the reduction of anxiety among primiparous women before cesarean section, the BRT was shown more effective. These nonpharmacologic methods are safe and cost-effective and can improve well-being among women undergoing this invasive procedure. They can be used along with pharmacologic methods for reducing overreliance on medications.
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Buonanno P, Marra A, Iacovazzo C, Vargas M, Nappi S, de Siena AU, Servillo G. Preoperative anxiety during COVID-19 pandemic: A single-center observational study and comparison with a historical cohort. Front Med (Lausanne) 2022; 9:1062381. [PMID: 36590950 PMCID: PMC9797972 DOI: 10.3389/fmed.2022.1062381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/14/2022] [Indexed: 12/23/2022] Open
Abstract
Background Preoperative anxiety is a common sensation experienced by patients undergoing surgical interventions. It can influence intraoperative and postoperative management through the activation of the neuroendocrine system, leading to tachycardia, hypertension, pulmonary complications, higher consumption of anesthetic drugs, and increased postoperative pain. Our aim was to investigate the level of preoperative anxiety during the COVID-19 pandemic; we also compared it to the preoperative anxiety of a historical cohort before the outbreak. Methods This is a single-center observational study. We enrolled 314 patients during the pandemic from May 2021 to November 2021, and our historical cohort consisted of 122 patients enrolled from July 2015 to May 2016 in the university hospital "Federico II" of Naples. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) and the State-Trait Anxiety Inventory (STAI) were used to evaluate preoperative anxiety. In particular, APAIS measures preoperative anxiety and the need for information, and STAI assesses state and trait anxiety through STAI-Y1 and STAI-Y2, respectively. We analyzed APAIS and STAI scores in our population stratified on the basis of age, gender, marital status, previous surgical experiences, and type of surgery, and we compared them to our historical cohort. Statistical analysis was performed through a t-test and ANOVA for parametric data, and the Mann-Whitney and Kruskal-Wallis tests for non-parametric data. Linear regression was used to investigate the correlation between demographic data and the scores of STAI and APAIS in both groups. Results Our results showed that state and preoperative anxiety remained stable, whereas trait anxiety increased in all the subgroups analyzed. Discussion Even if state anxiety is considered a variable characteristic of the emotional sphere and trait anxiety a stable element, our findings suggested that COVID-19 deeply influenced trait anxiety, thus altering the patients' psychological foundations.
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Korkusuz M, Et T, Et T. Did the COVID-19 Pandemic Change the Anaesthesia Preferences of Pregnant Women for Caesarean Section? Turk J Anaesthesiol Reanim 2022; 50:416-423. [PMID: 36511490 PMCID: PMC9885785 DOI: 10.5152/tjar.2022.22058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE The COVID-19 disease has become a new cause of anxiety for pregnant women regarding caesarean sections. The purpose of the present study was to investigate the anaesthesia preferences of pregnant women who preferred general anaesthesia in their previous caesarean sections during the COVID-19 pandemic. METHODS A total of 140 pregnant women between the ages of 18 and 45, who had undergone elective caesarean section under general anaesthesia, were included in the study. Amsterdam Preoperative Anxiety and Information Scale and Beck Anxiety Inventory were applied. The primary cause of anxiety and anaesthesia preference was asked and recorded. RESULTS It was found that 50.7% (71/140) of the pregnant women who preferred general anaesthesia in their previous caesarean sections preferred regional anaesthesia during the COVID-19 pandemic. It was also found that patients with primary anxiety because of COVID-19 contagion preferred regional anaesthesia more (36/55), and the primary reason for anxiety in these patients was COVID-19 contamination anxiety (36/71). CONCLUSIONS Informing the patients about the pandemic precautions in the surgery room and in the hospital during the pandemic, as well as routine information in the preoperative anaesthesia appointment, may be effective in the choice of regional anaesthesia, which is considered to have a low risk of transmission.
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Ji W, Sang C, Zhang X, Zhu K, Bo L. Personality, Preoperative Anxiety, and Postoperative Outcomes: A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12162. [PMID: 36231463 PMCID: PMC9565184 DOI: 10.3390/ijerph191912162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 09/21/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
Research has shown that personality is associated with anxiety levels in the general population. However, little is known about the relationship between personality and preoperative anxiety and the subsequent health outcomes in patients undergoing surgery. Therefore, this review aimed to identify studies that explored the relationship between personality traits and preoperative anxiety, as well as their association with postoperative outcomes. Existing literature shows that anxiety may play an intermediary role in the relationship between personality and postoperative outcomes. Severe anxiety may partially explain the adverse effects of certain personality traits, such as neuroticism, on postoperative outcomes. However, the relationship between personality traits, preoperative anxiety, and postoperative outcomes remains unclear. Interventions such as clinical evaluation, preoperative counseling, and management strategies can be of great value in identifying and resolving patients' anxiety and negative emotions to improve postoperative outcomes.
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Affiliation(s)
- Wentao Ji
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Chao Sang
- Department of Anesthesiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201620, China
| | - Xiaoting Zhang
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Keming Zhu
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
| | - Lulong Bo
- Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai 200433, China
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19
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Sertcakacilar G, Yildiz GO, Bayram B, Pektas Y, Cukurova Z, Hergunsel GO. Comparing Preoperative Anxiety Effects of Brachial Plexus Block and General Anesthesia for Orthopedic Upper-Extremity Surgery: A Randomized, Controlled Trial. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:1296. [PMID: 36143973 PMCID: PMC9504088 DOI: 10.3390/medicina58091296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 08/25/2022] [Accepted: 09/14/2022] [Indexed: 12/05/2022]
Abstract
Background and objectives: Preoperative anxiety is an enormous feeling of fear that is seen in all patients undergoing surgery. The severity of anxiety may vary depending on the type of surgery and anesthesia to be performed. The aim of this study is to compare the effects of brachial plexus blocks and general anesthesia methods on preoperative anxiety levels in patients who will undergo orthopedic upper-extremity surgery and to determine the factors affecting anxiety. Materials and Methods: After randomization, the Amsterdam Preoperative Anxiety and Knowledge Scale (APAIS) questionnaire was applied to the patients to determine the preoperative anxiety level, and then anesthesia was applied according to the anesthesia type determined. Pain scores (1, 8, 16, and 24 h) and total opioid consumption of the patients were recorded postoperatively. Results: The APAIS score of the patients in the general anesthesia (GA) group was significantly higher (p = 0.021). VAS score medians at 1, 4, and 8 h postoperatively were found to be significantly higher in the GA group (p < 0.001, p < 0.001 and p = 0.044, respectively). Conclusions: USG-guided BPB may cause less anxiety than GA in patients who will undergo elective upper-extremity surgery. However, these patients have moderate anxiety, although it is more associated with advanced age, female gender, and education level.
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Affiliation(s)
- Gokhan Sertcakacilar
- Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Department of Anesthesiology and Reanimation, University of Health Science, Bakırköy Dr. Sadi Konuk Education and Research Hospital, 34147 Istanbul, Turkey
| | - Gunes Ozlem Yildiz
- Department of Anesthesiology and Reanimation, University of Health Science, Bakırköy Dr. Sadi Konuk Education and Research Hospital, 34147 Istanbul, Turkey
| | - Berhan Bayram
- Department of Orthopedic Surgery and Sport Medicine, University of Acıbadem, Acıbadem Altunizade Hospital, 34662 Istanbul, Turkey
| | - Yaser Pektas
- Department of Anesthesiology and Reanimation, University of Health Science, Bakırköy Dr. Sadi Konuk Education and Research Hospital, 34147 Istanbul, Turkey
| | - Zafer Cukurova
- Department of Anesthesiology and Reanimation, University of Health Science, Bakırköy Dr. Sadi Konuk Education and Research Hospital, 34147 Istanbul, Turkey
| | - Gulsum Oya Hergunsel
- Department of Anesthesiology and Reanimation, University of Health Science, Bakırköy Dr. Sadi Konuk Education and Research Hospital, 34147 Istanbul, Turkey
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20
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Kanyeki T, Mung'ayi V, Bal R, Odaba D. Effect of video-based information on preoperative State trait anxiety inventory scores in adult patients presenting for elective caesarean section: a randomized controlled trial. Afr Health Sci 2022; 22:117-124. [PMID: 36910414 PMCID: PMC9993282 DOI: 10.4314/ahs.v22i3.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Preoperative anxiety is a common occurrence in patients presenting for surgery with a reported incidence of up to 80%. Increased preoperative anxiety has been associated with increased morbidity. Provision of information relating to surgery and anaesthesia to patients has been proven to have benefit in allaying anxiety. However, the best format of information dissemination remains unknown. Objective To determine the effect of video information in addition to the pre-anaesthetic review on the mean preoperative State anxiety inventory (STAI-S) score in adult patients presenting for elective caesarean section under spinal anaesthesia at Aga Khan University Hospital, Nairobi (AKUHN), and to determine the prevalence of preoperative anxiety in the obstetric population presenting for elective caesarean section at AKUHN. Methods Thirty-seven adult patients booked for elective caesarean section under spinal anesthesia were randomly assigned to one of two groups. In the study arm; a video was shown to the participants in addition to the standard pre-anaesthetic review. In the control arm the participants only had a standard pre-anaesthetic review. Results The mean STAI-T score in the sampled population was 45.64 (SD 5.625). The mean baseline STAI-S score was 46.32 (SD 4.911). There was no statistically significant difference in change in STAI score between the video and control arms (p>0.05). Conclusion On the basis of this study among this population, there was no benefit demonstrated from the use of an information video about spinal anaesthesia on anxiety levels in obstetric patients presenting for a first time spinal.
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Affiliation(s)
| | | | - Rajpreet Bal
- Department of Anaesthesia, Aga Khan University, East Africa
| | - David Odaba
- Department of Anaesthesia, Aga Khan University, East Africa
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21
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Fentie Y, Yetneberk T, Gelaw M. Preoperative anxiety and its associated factors among women undergoing elective caesarean delivery: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:648. [PMID: 35978308 PMCID: PMC9382617 DOI: 10.1186/s12884-022-04979-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 08/09/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Anxiety is a behavioral expression of tension and unpleasant emotion that arises from multifactorial dimensions that might increase the mortality of patients during anesthesia and surgery. This study aimed to verify the prevalence and associated factors of preoperative anxiety among women undergoing elective cesarean delivery. METHOD A cross-sectional study design was conducted on a total of 392 patients who underwent elective cesarean delivery in Debre Tabor Comprehensive Specialized Hospital, in North Central Ethiopia from October 15, 2020, to September 15, 2021. Data was collected using a validated Amsterdam questionnaire, after translating to the local language (Amharic). Descriptive statistics were expressed in percentages and presented in tables. Bivariable and multivariable logistic analyses were done to identify factors associated with preoperative anxiety. The statistical significance level was set at P < 0.05 with 95% CI. RESULTS The overall prevalence of preoperative anxiety in women undergoing elective cesarean delivery was 67.9 [95% CI = (63.0-72.7)]. Participants who came from rural areas [AOR = 2.65; 95%CI: 1.27-5.53], farmers [AOR = 2.35; 95%CI: 1.02-5.40], participants with no previous surgical and anesthesia history [AOR = 2.91; 95%CI: 1.69-5.01], and primiparous women [AOR = 1.69; 95%CI: 1.01-2.83] were more significantly associated with preoperative anxiety. CONCLUSION The prevalence of preoperative anxiety among elective cesarean deliveries was found to be high. So, preoperative maternal counseling and anxiety reduction services should therefore be given top priority, particularly for those women who came from rural areas, are farmers, have no prior surgical or anesthetic experience, and are primiparous.
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Affiliation(s)
- Yewlsew Fentie
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, P.O.Box: 272, Debre Tabor, Ethiopia.
| | - Tikuneh Yetneberk
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, P.O.Box: 272, Debre Tabor, Ethiopia
| | - Moges Gelaw
- Departement of Anesthesia, College of Medicine and Health Sciences, Debre Tabor University, P.O.Box: 272, Debre Tabor, Ethiopia
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22
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Woldegerima Berhe Y, Belayneh Melkie T, Fitiwi Lema G, Getnet M, Chekol WB. The overlooked problem among surgical patients: Preoperative anxiety at Ethiopian University Hospital. Front Med (Lausanne) 2022; 9:912743. [PMID: 35983091 PMCID: PMC9378856 DOI: 10.3389/fmed.2022.912743] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Anxiety was repeatedly reported as the worst aspect of the perioperative time. The objective of this study was to assess the prevalence of preoperative anxiety among adult surgical patients at University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia. Methodology A hospital-based cross-sectional study was conducted among surgical patients at the university hospital. After obtaining ethical approval, 407 surgical patients were approached during the preoperative period. Preoperative anxiety was assessed by State-Trait Anxiety Inventory. The association between variables was determined by using binary logistic regression analysis. Strength of association was described in adjusted odds ratio (AOR), and a p-value < 0.05 at 95% confidence interval was considered statistically significant. Results A total of 400 patients were included in this study with a 98.3% response rate. Preoperative anxiety was observed among 237 (59.3%) patients, and the median (IQR) STAI score was 50 (40-56.7); age, ≥ 60 years (AOR: 5.7, CI: 1.6-20.4, P: 0.007); emergency surgery (AOR: 2.5, CI: 1.3-4.7, P: 0.005); preoperative pain (AOR: 2.6, CI: 1.2-5.4, P: 0.005); and rural residency (AOR: 1.8, CI: 1.1-2.9, P: 0.031) were found significantly associated with preoperative anxiety. Conclusion The prevalence of preoperative anxiety among surgical patients was high. Older age (≥ 60 years), emergency surgery, preoperative pain, and rural residency were found significantly associated with preoperative anxiety. Assessment for preoperative anxiety should be a routine component of preoperative assessment of both elective and emergency surgical patients. Preoperative pain should be appropriately managed as it can help to reduce preoperative anxiety. Optimal anxiety reduction methods should be investigated and implemented in the hospital.
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Affiliation(s)
| | | | | | - Marye Getnet
- Department of Emergency and Critical Care Nursing, University of Gondar, Gondar, Ethiopia
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Shewangzaw Engda A, Belay Yigzaw H, Alemnew Engdaw N, Admasu Basha E, Adem A, Dargie Wubetu A, Misganaw Kebede W, Atinafu BT, Nigussie Tarekegn F, Abate Belew M. Magnitude of Preoperative Anxiety and Associated Factors Among Adult Surgical Patients in Debre Berhan Comprehensive Specialized Hospital. Int J Gen Med 2022; 15:5999-6007. [PMID: 35818581 PMCID: PMC9270893 DOI: 10.2147/ijgm.s369921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 06/23/2022] [Indexed: 11/23/2022] Open
Abstract
Background Anxiety is an un-pleasurable emotional state associated with psychophysiological changes in response to an intra-psychic conflict. The perioperative period is one of the worrying events for most surgical patients. Despite preoperative anxiety having many negative consequences on post-operative physical and mental health, no adequate information on the degree to which the preoperative period exposed clients to preoperative anxiety and its associated factors. Objective To assess the prevalence of preoperative anxiety and associated factors among adult surgical patients in Debre Berhan Comprehensive Specialized Hospital, Ethiopia. Methods Institution-based cross-sectional study was conducted from June 1, 2020, to August 30, 2020. State-Trait Anxiety Inventory Scale (S-STAI) was used to measure the level of pre-operative anxiety. A systematic random sampling technique was employed to collect the data. The data were entered to Epi-Data version 4.6 and exported to SPSS version 25 for data analysis. A statistically significant association was declared at a p-value less than 0.05. Results A total of 330 patients were enrolled in the study with a response rate of 93.2%. The prevalence of a high level of preoperative anxiety was 53.6% (95% CI (49.6-58.7)). Being female 3.2 (2.19, 3.71) illiterate 4.1 (2.01, 15.39), fear of death 2.12 (1.30, 3.44), results of operation 2.60 (1.75, 4.18), postoperative pain 2.35 (1.37, 4.02), and surgical complication 1.9 (1.03, 12.13) were statistically significant factors. Conclusion Preoperative anxiety affects more than half of surgical patients which is a high and serious health burden. Additionally, this study revealed that being female, illiterate, fear of death, having a history of surgical complications and fear of complications, and fear of postoperative pain were significantly associated with preoperative anxiety. Assessing during the preoperative period helps to detect and ameliorate the problem. Preoperative counseling and informed consent taken as a prerequisite for surgery will help in reducing preoperative anxiety.
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Affiliation(s)
- Abayneh Shewangzaw Engda
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Hailu Belay Yigzaw
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Nigus Alemnew Engdaw
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Elyas Admasu Basha
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Ahmed Adem
- Department of Nursing, Psychiatry Unit, College of Health Sciences and Medicine, Samara University, Samara, Ethiopia
| | - Abate Dargie Wubetu
- Department of Psychiatry, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Worku Misganaw Kebede
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Bantealem Tilaye Atinafu
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Fetene Nigussie Tarekegn
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
| | - Makda Abate Belew
- Department of Nursing, College of Health Sciences and Medicine, Debre Berhan University, Debre Berhan, Ethiopia
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Favre-Félix J, Laurent V, Branche P, Huissoud C, Raffin M, Pradat P, Aubrun F, Dziadzko M. Auricular Acupuncture for Preoperative Anxiety in Parturient Women with Scheduled Cesarean Section: A Randomized Placebo-Controlled Blind Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:569-578. [PMID: 35394895 DOI: 10.1089/jicm.2021.0346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Introduction: Preoperative anxiety before cesarean section is a major issue. Nonpharmacologic anxiety control is believed to be more suitable in pregnant women. Auricular acupuncture (AA) is an inexpensive, easy-to-use, and validated intervention to reduce anxiety in different surgical settings. We evaluated the effect of AA on preoperative cesarean section anxiety. Methods: In a prospective, blind, controlled trial, pregnant women with a scheduled cesarean section under spinal anesthesia were randomized to receive AA with needle, AA without needle (sham), or usual care (no intervention). Anxiety level was assessed by using a visual analogue scale for anxiety (VAS-A; 0-minimal anxiety, 100-maximal anxiety) at three time points: inclusion (pre-induction room-T0), when entering the operating room (T1), and before incision (T2). The primary outcome was the VAS-A variation (percentage changes) between T0 and T1 in the AAe group compared with that in the sham AA group. The secondary outcomes were the VAS-A variation between T0 and T1 in the AA group compared with that in the control group, and the variation between T0 and T2 compared between the three groups, the effect of AA on parasympathetic tone, and the incidence of adverse effects. Results: In women immediately before anesthesia for cesarean section, the AA produced a 19% decrease of anxiety, compared with a 21% anxiety increase in sham AA, which is significantly different. The effect of AA was more present in women with low initial anxiety. The proportion of patients reaching clinically significant anxiety reduction (>33% from the initial level) was 2.5 times higher in the AA group (p = 0.02) compared with the sham group. No differences in anxiety variations were found compared with the no-intervention group. No effect of AA was noted on parasympathetic tone. Conclusion: Compared with sham, AA decreased maternal anxiety level when arriving in the operation room and just before the beginning of the cesarean section, with a trend toward improvement compared with usual care.
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Affiliation(s)
- Jeremy Favre-Félix
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Virginie Laurent
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Patricia Branche
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Cyril Huissoud
- Service de Gynécologie-Obstétrique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Stem Cell and Brain Research Institute, U846-INSERM, Bron, France
| | - Mahé Raffin
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Pierre Pradat
- Centre de Recherche Clinique, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
| | - Frederic Aubrun
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Research on Healthcare Performance (RESHAPE), U1290-INSERM et Université Claude Bernard Lyon 1, Lyon, France
| | - Mikhail Dziadzko
- Service d'Anesthésie, Réanimation, Douleur, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Université Claude Bernard Lyon 1, Lyon, France
- Research on Healthcare Performance (RESHAPE), U1290-INSERM et Université Claude Bernard Lyon 1, Lyon, France
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Hung KH, Tsao SL, Yang SF, Wang BY, Huang JY, Li WT, Yeh LT, Lin CH, Chen YY, Yeh CB. Association of General Anesthesia and Neuraxial Anesthesia in Caesarean Section with Maternal Postpartum Depression: A Retrospective Nationwide Population-Based Cohort Study. J Pers Med 2022; 12:jpm12060970. [PMID: 35743754 PMCID: PMC9224722 DOI: 10.3390/jpm12060970] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 02/01/2023] Open
Abstract
Although cesarean section (CS) has become a common method of child delivery in recent decades, the choice between general anesthesia (GA) and neuraxial anesthesia (NA) for CS must be carefully considered. Depending on the type of anesthesia used in CS, a major outcome observed is the occurrence of postpartum depression (PPD). This study investigated the association between PPD risk and the anesthesia method used in CS by using data from three linked nationwide databases in Taiwan, namely, the National Health Insurance Research Database, the National Birth Reporting Database, and the National Death Index Database. After propensity score matching by baseline depressive disorders, maternal demographics, status at delivery, infant’s health, maternal diseases during pregnancy, and age of partner, we included women who had natural births (n = 15,706), cesarean sections with GA (n = 15,706), and cesarean sections with NA (n = 15,706). A conditional logistic regression was used to estimate the odds ratios and 95% confidence intervals (CIs) of PPDs, including depression, sleep disorder, and medication with hypnotics or antidepressants, under anesthesia during CS. The prevalence rates of combined PPDs were 26.66%, 43.87%, and 36.30% in natural births, CS with GA, and CS with NA, respectively. In particular, the proportions of postpartum use of hypnotic drugs or antidepressants were 21.70%, 39.77%, and 31.84%, which were significantly different. The aORs (95% CIs) were 2.15 (2.05–2.25) for the included depressive disorders, 1.10 (1.00–1.21) for depression, 1.03 (0.96–1.11) for sleep disorder, and 2.38 (2.27–2.50) for medication with hypnotics or antidepressants in CS with GA compared with natural births. Women who underwent CS with GA had a significantly higher risk of depressive disorders and a higher need for antidepressants for sleep problems than those who underwent CS with NA. The risks of PPD were significantly associated with the anesthesia method, especially GA. Our results can assist physicians in carefully considering the appropriate anesthesia method for CS delivery, particularly with regard to postpartum drug abuse and drug safety.
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Affiliation(s)
- Kuo-Hsun Hung
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (K.-H.H.); (S.-F.Y.); (B.-Y.W.); (J.-Y.H.); (L.-T.Y.)
| | - Shao-Lun Tsao
- Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan 320, Taiwan; (S.-L.T.); (W.-T.L.)
- Department of Anesthesiology, Changhua Christian Hospital, Changhua 500, Taiwan
| | - Shun-Fa Yang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (K.-H.H.); (S.-F.Y.); (B.-Y.W.); (J.-Y.H.); (L.-T.Y.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Bo-Yuan Wang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (K.-H.H.); (S.-F.Y.); (B.-Y.W.); (J.-Y.H.); (L.-T.Y.)
- Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Jing-Yang Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (K.-H.H.); (S.-F.Y.); (B.-Y.W.); (J.-Y.H.); (L.-T.Y.)
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 402, Taiwan
| | - Wen-Tyng Li
- Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan 320, Taiwan; (S.-L.T.); (W.-T.L.)
| | - Liang-Tsai Yeh
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (K.-H.H.); (S.-F.Y.); (B.-Y.W.); (J.-Y.H.); (L.-T.Y.)
- Department of Anesthesiology, Changhua Christian Hospital, Changhua 500, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
| | - Cheng-Hung Lin
- Department of Information Technology, Chung Shan Medical University Hospital, Taichung 402, Taiwan;
- Department of Medical Informatics, Chung Shan Medical University, Taichung 402, Taiwan
| | - Yin-Yang Chen
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Department of Surgery, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Correspondence: (Y.-Y.C.); (C.-B.Y.)
| | - Chao-Bin Yeh
- Institute of Medicine, Chung Shan Medical University, Taichung 402, Taiwan; (K.-H.H.); (S.-F.Y.); (B.-Y.W.); (J.-Y.H.); (L.-T.Y.)
- Department of Emergency Medicine, School of Medicine, Chung Shan Medical University, Taichung 402, Taiwan
- Department of Emergency Medicine, Chung Shan Medical University Hospital, Taichung 402, Taiwan
- Correspondence: (Y.-Y.C.); (C.-B.Y.)
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The Association between General Anesthesia and New Postoperative Uses of Sedative-Hypnotics: A Nationwide Matched Cohort Study. J Clin Med 2022; 11:jcm11123360. [PMID: 35743431 PMCID: PMC9224548 DOI: 10.3390/jcm11123360] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/01/2022] [Accepted: 06/09/2022] [Indexed: 11/17/2022] Open
Abstract
Sedative−hypnotic misuse is associated with psychiatric diseases and overdose deaths. It remains uncertain whether types of anesthesia affect the occurrence of new postoperative uses of sedative−hypnotics (NPUSH). We used reimbursement claims data of Taiwan’s National Health Insurance and conducted propensity score matching to compare the risk of NPUSH between general and neuraxial anesthesia among surgical patients who had no prescription of oral sedative−hypnotics or diagnosis of sleep disorders within the 12 months before surgery. The primary outcome was NPUSH within 180 days after surgery. Multivariable logistic regression models were used to calculate the adjusted odds ratio (aOR) and 95% confidence interval (CI). A total of 92,222 patients were evaluated after matching. Among them, 15,016 (16.3%) had NPUSH, and 2183 (4.7%) were made a concomitant diagnosis of sleep disorders. General anesthesia was significantly associated both with NPUSH (aOR: 1.17, 95% CI: 1.13−1.22, p < 0.0001) and NPUSH with sleep disorders (aOR: 1.11, 95% CI: 1.02−1.21, p = 0.0212) compared with neuraxial anesthesia. General anesthesia was also linked to NPUSH that occurred 90−180 days after surgery (aOR: 1.12, 95% CI: 1.06−1.19, p = 0.0002). Other risk factors for NPUSH were older age, female, lower insurance premium, orthopedic surgery, specific coexisting diseases (e.g., anxiety disorder), concurrent medications (e.g., systemic steroids), postoperative complications, perioperative blood transfusions, and admission to an intensive care unit. Patients undergoing general anesthesia had an increased risk of NPUSH compared with neuraxial anesthesia. This finding may provide an implication in risk stratification and prevention for sedative−hypnotic dependence after surgery.
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Bedaso A, Mekonnen N, Duko B. Prevalence and factors associated with preoperative anxiety among patients undergoing surgery in low-income and middle-income countries: a systematic review and meta-analysis. BMJ Open 2022; 12:e058187. [PMID: 35277412 PMCID: PMC8919464 DOI: 10.1136/bmjopen-2021-058187] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 02/15/2022] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES This review aimed to determine the pooled prevalence of preoperative anxiety and its associated factors among patients undergoing surgery in low/middle-income countries (LMICs). METHODS We searched PubMed, SCOPUS, CINAHL, Embase and PsychINFO to identify peer-reviewed studies on the prevalence and factors associated with preoperative anxiety among patients undergoing surgery using predefined eligibility criteria. Studies were pooled to estimate the prevalence of preoperative anxiety using a random-effect meta-analysis model. Heterogeneity was assessed using I² statistics. Funnel plot asymmetry and Egger's regression tests were used to check for publication bias. RESULT Our search identified 2110 studies, of which 27 studies from 12 countries with 5575 participants were included in the final meta-analysis. Of the total 27 studies, 11 used the State-Trait Anxiety Inventory to screen anxiety, followed by the Amsterdam Preoperative Anxiety and Information scale, used by four studies. The pooled prevalence of preoperative anxiety among patients undergoing surgery in LMICs was 55.7% (95% CI 48.60 to 62.93). Our subgroup analysis found that a higher pooled prevalence of preoperative anxiety was found among female surgical patients (59.36%, 95% CI 48.16 to 70.52, I2=95.43, p<0.001) and studies conducted in Asia (62.59%, 95% CI 48.65 to 76.53, I2=97.48, p<0.001). CONCLUSION Our meta-analysis indicated that around one in two patients undergoing surgery in LMICs suffer from preoperative anxiety, which needs due attention. Routine screening of preoperative anxiety symptoms among patients scheduled for surgery is vital. PROSPERO REGISTRATION NUMBER CRD42020161934.
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Affiliation(s)
- Asres Bedaso
- Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia
- Australian Centre for Public and Population Health Research, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Nibretie Mekonnen
- Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia
| | - Bereket Duko
- Hawassa University, College of Medicine and Health Sciences, School of Nursing, Hawassa, Ethiopia
- Curtin University, School of Population Health, Department of Public Health, Perth, Western Australia, Australia
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Ferede YA, Bizuneh YB, Workie MM, Admass BA. "Prevalence and associated factors of preoperative anxiety among obstetric patients who underwent cesarean section": A cross-sectional study. Ann Med Surg (Lond) 2022; 74:103272. [PMID: 35198163 PMCID: PMC8844776 DOI: 10.1016/j.amsu.2022.103272] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/08/2022] [Accepted: 01/23/2022] [Indexed: 01/26/2023] Open
Abstract
Background Anxiety is the most common problem in the preoperative period. This anxiety increases postoperative pain, delay healing, and prolong the hospital stay. Among the surgical population, a higher level of preoperative anxiety has been seen in obstetric patients. Objective The aim of this study was to assess the prevalence and associated factors of preoperative anxiety among obstetric patients undergoing cesarean section. Methods An institutional-based cross-sectional study was conducted from January 01, 2021, to May 30, 2021. A total of 376 obstetric patients who underwent cesarean sections were included. Descriptive statistics, cross-tabs, and binary logistic regression analysis were performed to identify the association shivering and independent variables. The strength of the association was presented using an adjusted odds ratio with a 95% confidence interval and a p-value<0.05 was considered as statistically significant state versions of state-trait anxiety inventory scale (S-STAI) were used for this study. Results The overall prevalence rate of preoperative anxiety was 63% (95% CI: 58.2, 68.1). The patient's preoperative mean anxiety score of STAI was (43.81 ± 8.81). There was a high level of preoperative anxiety in patients undergoing emergency cesarean section as compared to elective patients. Patients' age less than 30 years, level of education, and previous anesthesia and surgery exposure were also highly associated with the dependent variable. Conclusion In this study, fear of complications and fear of death result of operation were the most common factors responsible for preoperative anxiety while few patients were anxious about financial loss and osmotic issues. The prevalence rate of preoperative anxiety was 63% among obstetric patients. Preoperative anxiety was highly related to fear of complications and fear of death. Age, Level of education were significantly associated with preoperative anxiety. Previous anesthesia exposure was also significantly associated with anxiety. Preoperative anesthesia visits are important to reduce anxiety.
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Affiliation(s)
- Yonas Admasu Ferede
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Yosef Belay Bizuneh
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Misganaw Mengie Workie
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Ethiopia
| | - Biruk Adie Admass
- Department of Anesthesia, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Samalea Suarez N, Hallet C, Lois F, Joris J, Brichant J. Effect of walking to the operating room on preoperative anxiety in patients scheduled for outpatient laser therapy for venous insufficiency. A monocentric randomized study. ACTA ANAESTHESIOLOGICA BELGICA 2021. [DOI: 10.56126/72.4.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Preoperative anxiety in day surgery is associated with a higher incidence of post-operative complications such as postoperative nausea and vomiting, pain or unplanned admission.
Objectives: To evaluate the effect of walking to the operating room (OR) on anxiety in ambulatory patients undergoing minimal invasive laser therapy for venous insufficiency.
Design and setting: Randomized study in a tertiary hospital between May and November 2019.
Methods: 100 patients scheduled for ambulatory laser therapy for venous insufficiency were included. Patients were randomized to walk to the OR (study group, n=50) on even weeks or to lie in a bed to the OR (control group, n=50) on odd weeks.
Main outcome measures: Baseline anxiety was assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and Numerical Rating Scale of anxiety (anxiety-NRS) from 0 to 10 when prepared for departure to OR. Preoperative anxiety-NRS assessment was performed upon arrival in the OR.
Results: Patients’ characteristics were similar in both groups. Baseline anxiety-NRS was significantly lower in the study group than in the control group: 2 (1-3) vs. 4 (2-6.5) (p=.013) respectively. No difference was observed between the groups for preoperative anxiety-NRS. A significant reduction in anxiety-NRS on arrival at the OR was observed in the control group compared with the study group (p=.019).
Conclusion: Walking to the OR does not reduce anxiety in ambulatory patients undergoing minimal invasive laser therapy for venous insufficiency. But, preparing them to walk to the OR could possibly reduce baseline anxiety while waiting for surgery.
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Oliveira PSC, Sant'Anna BC, Seixas NB, Mendonça JA. Low-dose midazolam for anxiolysis for pregnant women undergoing cesarean delivery: a randomized trial. Braz J Anesthesiol 2021; 72:450-456. [PMID: 34637858 PMCID: PMC9373564 DOI: 10.1016/j.bjane.2021.07.039] [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] [Received: 04/09/2020] [Revised: 07/01/2021] [Accepted: 07/10/2021] [Indexed: 10/26/2022] Open
Abstract
INTRODUCTION Anxiety and fear are common among pregnant women undergoing cesarean delivery. In addition to psychologically unpleasant, they can elicit endocrine and metabolic changes. Administration of benzodiazepines in this patient group is uncommon and investigation focusing on the topic is rare. This study aimed to determine anxiolysis efficacy of low-dose midazolam administered preoperatively, right before cesarean delivery, and to evaluate whether its administration impacts neonatal vitality, maternal consciousness, and recall of the moment the baby was born. METHODS Fifty pregnant women with indication for cesarean delivery were included in this randomized, double-blind, placebo-controlled clinical study and allocated into two groups of 25 participants each (Midazolam and Control group). Midazolam (0.0125 mg.kg-1) or a placebo solution was administered immediately before spinal anesthesia and the anxiolytic effect was assessed using a visual analogue scale before and after administration. We registered the Apgar score at 1 and 5 minutes, the Ramsay scale and recall of the moment of birth, that was assessed 90 minutes after birth. RESULTS Pregnant women from the Midazolam group presented a 1.3-point reduction in anxiety on the visual analogue scale, while the Control group showed virtually no change (p = 0.027). We observed no statistically significant changes in Apgar scores, level of maternal consciousness and recall of the moment of delivery. CONCLUSIONS Low-dose midazolam can provide anxiety management in pregnant women undergoing cesarean delivery with no significant undesirable effects.
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Affiliation(s)
- Pedro Solfa Campos Oliveira
- Pontifícia Universidade Católica de Campinas, Programa de Pós-graduação em Ciências da Saúde, Campinas, SP, Brazil; Hospital da Pontifícia Universidade Católica de Campinas, Serviço de Anestesiologia, Campinas, SP, Brazil.
| | - Beatriz Cesar Sant'Anna
- Hospital da Pontifícia Universidade Católica de Campinas, Serviço de Anestesiologia, Campinas, SP, Brazil
| | - Náira Bueno Seixas
- Hospital da Pontifícia Universidade Católica de Campinas, Serviço de Anestesiologia, Campinas, SP, Brazil
| | - José Alexandre Mendonça
- Pontifícia Universidade Católica de Campinas, Programa de Pós-graduação em Ciências da Saúde, Campinas, SP, Brazil; Hospital da Pontifícia Universidade Católica de Campinas, Serviço de Reumatologia, Campinas, SP, Brazil
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Effects of Acupressure on Preoperative Acute Anxiety in Cesarean Section Under Spinal Anesthesia: A Double-Blind Randomized Controlled Study. Holist Nurs Pract 2021; 34:356-364. [PMID: 33060498 DOI: 10.1097/hnp.0000000000000413] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Anxiety during the preoperative period is a common problem experienced by women who will deliver by cesarean section. The use of nonpharmacological methods to control anxiety in pregnant women has been shown to be more appropriate. This double-blind randomized controlled experimental study was conducted to assess the effect of acupressure on acute anxiety developing before cesarean section under spinal anesthesia. In the present study, 82 pregnant women scheduled for surgery were randomly assigned to the acupressure and control groups including 40 and 42 persons, respectively. Acupressure was applied to HE-7 acupuncture points in the participants in the acupressure (intervention) group for 10 minutes before the surgery. The participants in the control group were subjected to the hospital protocol. Anxiety levels of the participating women were assessed twice preoperatively using the State-Trait Anxiety Inventory. Anxiety scores of the participants in the acupressure group before the procedure (49.13 ± 6.22) were higher than were those of the participants in the control group (41.71 ± 3.26); however, after the procedure, the anxiety scores decreased statistically significantly in the acupressure group (38.30 ± 4.45) compared with the control group (52.48 ± 7.30) (P < .001). Acupressure reduced the preoperative acute anxiety suffered by the participating pregnant women.
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Sriramka B, Mallik D, Singh J, Khetan M. Effect of hand-holding and conversation alone or with midazolam premedication on preoperative anxiety in adult patients-A randomised controlled trial. Indian J Anaesth 2021; 65:128-132. [PMID: 33776087 PMCID: PMC7983819 DOI: 10.4103/ija.ija_705_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/26/2020] [Accepted: 12/20/2020] [Indexed: 11/15/2022] Open
Abstract
Background and Aims: Anxiety causing stress is most profound before surgery. Anxiolytics are used routinely to combat perioperative anxiety. Studies have shown that hand-holding and communication are useful in reducing anxiety levels intraoperatively. This study compares the effectiveness of the same with pharmacological interventions in allaying preoperative anxiety. Material and Methods: This is a three-arm parallel-group randomised controlled trial. A total of 90 adult patients aged <45 years and of American Society of Anesthesiologists (ASA) grade 1–2, undergoing laparoscopic surgery were enroled in this study. Patients received either intravenous (IV) midazolam (group M) or hand-holding and conversation (group HC), or a combination of IV midazolam and holding and conversation (group HCM) in the preoperative room. Anxiety, heart rate (HR) and mean blood pressure (MBP) were recorded before and 20 minutes after the intervention. Anxiety was measured using the Amsterdam preoperative anxiety and information scale. The analysis of covariance (ANCOVA) test was done to analyse the difference between the groups. Results: The mean anxiety scores were significantly different in the three groups (p = 0.04) after intervention, with the lowest score in group HCM, followed by group HC and the highest score in group M. The mean heart rates were also significantly different in the three groups after intervention but MBP was not significantly different in the three groups. Conclusion: A combination of hand-holding and conversation and midazolam is best for allaying preoperative anxiety in patients undergoing laparoscopic surgeries than either method alone.
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Affiliation(s)
- Bhavna Sriramka
- Department of Anaesthesia and Critical Care, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | - Diptimayee Mallik
- Department of Anaesthesia and Critical Care, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | - Jayanti Singh
- Department of Anaesthesia and Critical Care, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | - Megha Khetan
- Department of Anaesthesia and Critical Care, IMS & SUM Hospital, Bhubaneswar, Odisha, India
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Does Anxiety Affect The Anesthesia Type Chosen By Cesarean Section Patients ? JOURNAL OF CONTEMPORARY MEDICINE 2020. [DOI: 10.16899/jcm.637534] [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] Open
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Global prevalence and determinants of preoperative anxiety among surgical patients: A systematic review and meta-analysis. INTERNATIONAL JOURNAL OF SURGERY OPEN 2020. [DOI: 10.1016/j.ijso.2020.05.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Quintana-Guardo F, Monterrosa-Castro Á, Beltrán-Barrios T. Frecuencia de ansiedad preoperatoria y factores asociados en gestantes programadas a cesárea. IATREIA 2019. [DOI: 10.17533/udea.iatreia.31] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Objetivo: estimar la frecuencia de la ansiedad preoperatoria (AP) y los factores asociados enlas gestantes programadas con cesárea electiva.Métodos: estudio transversal en mujeres con embarazo de término sin actividad uterina nicomplicaciones médicas, quirúrgicas u obstétricas, realizado previo a la intervención de cesárea electiva, en Cartagena, Colombia. Participación anónima y voluntaria con consentimiento informado. Se aplicó un formulario de características sociodemográficas y la versión en español de la escala Amsterdam Preoperative Anxiety and Information Scale (APAIS). Se realizó regresión logística no ajustada para observar la asociación de las variables cualitativas con AP, se estimó el coeficiente de correlación entre las puntuaciones de las dos subescalas del APAIS con las variables cuantitativas.Resultados: se estudiaron 326 embarazadas, con edad entre 28,5 ± 6,4 años; 7,9 % adolescentes; 24,2 % primigestantes; 81,9 % con cesárea anterior y 70,8 % sin otras cirugías previamente. El 45 % informó no estar de ningún modo preocupada por la cirugía o anestesia y el 7,8 % quería saber mucho más sobre el procedimiento. La frecuencia de AP y de la necesidad de tener mucha más información de la cirugía o anestesia fue del 9,2 %. El número de familiares en la sala de espera se correlacionó negativamente con AP, rho: -0,127 [IC 95 %: -0,232-0,019]. La necesidad de mucha más información sobre la cirugía o anestesia se asoció con el aumento en la frecuencia de AP, OR: 10,9 [IC 95 %: 4,54-26,36]. También lo fueron los estados civiles: unión libre y separada, con respecto a casada: OR: 3,7[IC 95 %: 1,5-9,2] y OR: 4,4 [IC 95 %: 1,0-19,3], respectivamente.Conclusión: la frecuencia de AP previa a la cesárea fue de 9,2 %. La necesidad de tener más información sobre la cirugía o anestesia se asoció diez veces mayor la presencia de AP y el número de familiares en la sala de espera se correlacionó negativamente con AP, pero el tamaño del coeficiente de correlación se interpretó como despreciable.
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Kizilkaya T, Gul A. Parameters that Affect the Comfort Level of Pregnant Women Before Cesarean Section: Fasting and Anxiety. J Perianesth Nurs 2019; 34:1265-1273. [PMID: 31474518 DOI: 10.1016/j.jopan.2019.05.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 05/16/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022]
Abstract
PURPOSE This study aimed to investigate whether fasting time and anxiety parameters affect pregnant women's preoperative comfort levels. DESIGN Cross-sectional descriptive study. METHODS Data were collected from pregnant women using the State-Trait Anxiety Inventory (STAI), General Comfort Questionnaire (GCQ), and Numerical Rating Scale. FINDINGS The mean age of the participants was 29.15 ± 4.54 years, and the spinal anesthesia rate was 65.5%. The mean fasting time was 13.16 ± 2.38 hours for solid food and 10.57 ± 2.91 hours for liquid food. The mean GCQ score was 129.82 ± 12.66, while the mean STAI subscale scores were 46.72 ± 9.37 and 43.65 ± 7.95. Moderately negative correlation was found between the total GCQ and STAI scores, while weak positive correlation was observed between the STAI score and the thirst sensation and mouth dryness. CONCLUSIONS The preoperative process negatively affects comfort levels of pregnant women. Interventions that reduce the fasting time and anxiety level of pregnant women will increase comfort.
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Stamenkovic DM, Rancic NK, Latas MB, Neskovic V, Rondovic GM, Wu JD, Cattano D. Preoperative anxiety and implications on postoperative recovery: what can we do to change our history. Minerva Anestesiol 2018; 84:1307-1317. [DOI: 10.23736/s0375-9393.18.12520-x] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Haršanji Drenjančević I, Drenjančević D, Davidović-Cvetko E, Drenjančević I, Gulam D, Kvolik S. DOES THE ANESTHESIA TECHNIQUE AFFECT ARTERIAL PRESSURE AND REGIONAL CEREBRAL OXYGEN SATURATION DURING SHOULDER ARTHROSCOPY IN THE BEACH CHAIR POSITION? Acta Clin Croat 2018; 57:473-479. [PMID: 31168180 PMCID: PMC6536278 DOI: 10.20471/acc.2018.57.03.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
- This study aimed to investigate the impact of posture and anesthesia techniques on blood pressure changes, heart rate and regional cerebral oxygen saturation during shoulder arthroscopy in the beach chair position (BCP). Sixty patients were included in this prospective cohort study: 30 patients mechanically ventilated and subjected to general anesthesia (GA) and 30 patients subjected to interscalene block (ISB) without mechanical ventilation. Noninvasive blood pressure, heart rate (HR), peripheral blood oxygen saturation and regional oxygen saturation of the brain were measured in twelve predefined points during perioperative period. The GA group patients had significantly lower mean arterial pressure and heart rate values compared to patients in ISB group during BCP (p<0.001). There was a significant difference in regional cerebral saturation between the groups measured only in points of induction and emergence from anesthesia in favor of GA group when receiving 100% oxygen (p<0.001). Changes in the mean arterial pressure and regional cerebral oxygen saturation for both brain hemispheres correlated only at the 10th minute after setting up BCP in GA patients (right, p=0.004 and left, p=0.003). This correlation did not exist in the ISB group patients at any of the points measured. Cerebral desaturation events recorded in both groups were not statistically significantly different. Results of this study demonstrated that GA preserved regional cerebral oxygenation in a safe range during BCP despite changes in the arterial blood pressure and heart rate in comparison to ISB.
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Affiliation(s)
| | - Domagoj Drenjančević
- 1Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek University Hospital Centre and Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Transfusion Medicine, Osijek University Hospital Centre and Department of Microbiology and Parasitology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Lavoslav Ružička College of Applied Sciences of Vukovar, Vukovar, Croatia; 4Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 5Department of Anesthesiology, Resuscitation and Intensive Medicine, Split University Hospital Centre, Split, Croatia
| | - Erna Davidović-Cvetko
- 1Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek University Hospital Centre and Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Transfusion Medicine, Osijek University Hospital Centre and Department of Microbiology and Parasitology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Lavoslav Ružička College of Applied Sciences of Vukovar, Vukovar, Croatia; 4Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 5Department of Anesthesiology, Resuscitation and Intensive Medicine, Split University Hospital Centre, Split, Croatia
| | - Ines Drenjančević
- 1Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek University Hospital Centre and Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Transfusion Medicine, Osijek University Hospital Centre and Department of Microbiology and Parasitology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Lavoslav Ružička College of Applied Sciences of Vukovar, Vukovar, Croatia; 4Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 5Department of Anesthesiology, Resuscitation and Intensive Medicine, Split University Hospital Centre, Split, Croatia
| | - Danijela Gulam
- 1Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek University Hospital Centre and Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Transfusion Medicine, Osijek University Hospital Centre and Department of Microbiology and Parasitology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Lavoslav Ružička College of Applied Sciences of Vukovar, Vukovar, Croatia; 4Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 5Department of Anesthesiology, Resuscitation and Intensive Medicine, Split University Hospital Centre, Split, Croatia
| | - Slavica Kvolik
- 1Department of Anesthesiology, Resuscitation and Intensive Medicine, Osijek University Hospital Centre and Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 2Department of Transfusion Medicine, Osijek University Hospital Centre and Department of Microbiology and Parasitology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 3Lavoslav Ružička College of Applied Sciences of Vukovar, Vukovar, Croatia; 4Department of Physiology and Immunology, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; 5Department of Anesthesiology, Resuscitation and Intensive Medicine, Split University Hospital Centre, Split, Croatia
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Mamtora PH, Kain ZN, Stevenson RS, Golianu B, Zuk J, Gold JI, Fortier MA. An evaluation of preoperative anxiety in Spanish-speaking and Latino children in the United States. Paediatr Anaesth 2018; 28:719-725. [PMID: 29962037 PMCID: PMC6109411 DOI: 10.1111/pan.13425] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND There is a large body of literature examining factors associated with children's preoperative anxiety; however, cultural variables such as ethnicity and language have not been included. AIMS The purpose of this investigation was to examine the role of Latino ethnicity and Spanish-speaking families in pediatric preoperative anxiety. METHODS Participants were 294 children aged 2-15 years of age undergoing outpatient, elective tonsillectomy and/or adenoidectomy surgery and general anesthesia. Participants were recruited and categorized into 3 groups: English-speaking non-Latino White (n = 139), English-speaking Latino (n = 88), and Spanish-speaking Latino (n = 67). Children's anxiety was rated at 2 time points before surgery: the time the child entered the threshold of the operating room (Induction 1) and the time when the anesthesia mask was placed (Induction 2). RESULTS Results from separate linear regression models at Induction 1 and Induction 2, respectively, showed that being from a Spanish-speaking Latino family was associated with higher levels of preoperative anxiety compared with being from an English-speaking family. In addition, young age and low sociability was associated with higher preoperative anxiety in children. CONCLUSION Clinicians should be aware that younger, less sociable children of Spanish-speaking Latino parents are at higher risk of developing preoperative anxiety and manage these children based on this increased risk.
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Affiliation(s)
- Pragati H. Mamtora
- UCI Center on Stress & Health, School of Medicine, University of California-Irvine, Irvine, USA
| | - Zeev N. Kain
- UCI Center on Stress & Health, School of Medicine, University of California-Irvine, Irvine, USA,Department of Anesthesiology and Perioperative Care, University of California-Irvine, Irvine, USA,Department of Pediatrics, Children’s Hospital of Orange County, Orange, USA,Yale Child Study Center, Yale University School of Medicine, New Haven, CT
| | - Robert S. Stevenson
- UCI Center on Stress & Health, School of Medicine, University of California-Irvine, Irvine, USA,Department of Anesthesiology and Perioperative Care, University of California-Irvine, Irvine, USA
| | - Brenda Golianu
- Department of Anesthesiology and Perioperative Medicine, Stanford University School of Medicine, USA
| | - Jeannie Zuk
- Departments of Surgery and Anesthesiology, Children’s Hospital Colorado, University of Colorado School of Medicine, USA
| | - Jeffrey I. Gold
- Keck School of Medicine, Departments of Anesthesiology, Pediatrics, and Psychiatry & Behavioral Sciences, University of Southern California, Children’s Hospital Los Angeles, USA
| | - Michelle A. Fortier
- UCI Center on Stress & Health, School of Medicine, University of California-Irvine, Irvine, USA,Department of Anesthesiology and Perioperative Care, University of California-Irvine, Irvine, USA,Department of Pediatric Psychology, Children’s Hospital of Orange County, Orange, USA
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Yeom JH, Oh MK, Ahn DW, Park SI. A loading dose of 1 µg/kg and maintenance dose of 0.5 µg/kg/h of dexmedetomidine for sedation under spinal anesthesia may induce excessive sedation and airway obstruction. Anesth Pain Med (Seoul) 2016. [DOI: 10.17085/apm.2016.11.3.255] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Jong Hoon Yeom
- Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Mi Kyung Oh
- Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Dae-woong Ahn
- Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Soo In Park
- Department of Anesthesiology and Pain Medicine, Hanyang University Guri Hospital, Guri, Korea
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Gómez-Urquiza JL, Hueso-Montoro C, Urquiza-Olmo J, Ibarrondo-Crespo R, González-Jiménez E, Schmidt-Riovalle J. A randomized controlled trial of the effect of a photographic display with and without music on pre-operative anxiety. J Adv Nurs 2016; 72:1666-76. [PMID: 26880679 DOI: 10.1111/jan.12937] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2015] [Indexed: 11/29/2022]
Abstract
AIMS To determine the effectiveness of photographic display at reducing pre-operative anxiety in an ear, nose and throat surgery unit; alone and in combination with music. BACKGROUND The waiting time prior to the surgery is often unpleasant and a time of anxiety for patients. Anxiety can affect physical recovery and psychological well-being; lengthening convalescence and hospital stay after the surgery. Improving pre-operative anxiety is a challenge with potential impacts on improving patients' satisfaction and well-being and decreasing the cost of care. DESIGN A clinical trial was conducted with two intervention groups and one control group. METHODS The sample consisted of 180 subjects from the otolaryngology major ambulatory surgery unit in a tertiary hospital in the province of Granada, with 60 subjects per group. The outcome variables measured were state anxiety, heart and respiratory rate and blood pressure. The data were collected from May-December 2013. RESULTS After the intervention, in the comparison between control group and photographic display group, all variables had lower means in the intervention group, although a significant P value was only obtained for respiratory rate using one-way anova test. When comparing control group and photographic display combined with music group, using one-way anova test, all mean values were lower in the intervention group and a significant P value were observed for all variables except diastolic blood pressure. CONCLUSION Photographic display in combination with music is more effective at reducing pre-operative anxiety than the standard intervention and photographic display alone.
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Affiliation(s)
| | - César Hueso-Montoro
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain
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