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Mattila N, Mazanikov M, Udd M, Kylänpää L, Lindström O, Pere P, Pöyhiä R, Ristikankare M. Topical pharyngeal anesthesia with articaine for gastroscopy: a double-blinded, randomized cross-over study in healthy volunteers. Scand J Gastroenterol 2024; 59:755-760. [PMID: 38441100 DOI: 10.1080/00365521.2024.2323504] [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: 12/28/2023] [Accepted: 02/21/2024] [Indexed: 05/30/2024]
Abstract
OBJECTIVES The benefits of topical pharyngeal anesthesia for gastroscopy remain under debate. Articaine, a local anesthetic with fast onset and offset of action as well as low systemic toxicity, could be a promising choice for topical anesthesia. The objective of this study was to assess whether topical pharyngeal anesthesia with articaine is beneficial in sedated gastroscopy. MATERIALS AND METHODS This randomized double-blinded cross-over study included nine volunteers who underwent two gastroscopies under conscious sedation. One was performed with topical pharyngeal anesthesia with articaine and the other with placebo. Hemodynamic parameters including autonomic nervous system state were recorded prior to and during the endoscopic procedure. The endoscopist and the volunteer assessed the endoscopy after the examination. RESULTS Topical pharyngeal anesthesia with articaine resulted in less discomfort during esophageal intubation and higher patient satisfaction with the procedure. Topical pharyngeal anesthesia with articaine did not increase satisfaction or facilitate the procedure as rated by the endoscopist. There were no clinically relevant differences in hemodynamic parameters. CONCLUSION The use of articaine for topical pharyngeal anesthesia results in less intubation-related discomfort and better satisfaction.
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Affiliation(s)
- Niklas Mattila
- Department of Perioperative and Intensive Care Medicine, Faculty of Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Maxim Mazanikov
- Department of Perioperative and Intensive Care Medicine, Faculty of Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Marianne Udd
- Department of Abdominal Surgery, Faculty of Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Leena Kylänpää
- Department of Abdominal Surgery, Faculty of Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Outi Lindström
- Department of Abdominal Surgery, Faculty of Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Pertti Pere
- Department of Perioperative and Intensive Care Medicine, Faculty of Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Reino Pöyhiä
- Palliative Medicine, Department of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Matti Ristikankare
- Department of Gastroenterology, Faculty of Medicine, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
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Yang X, Wang X, Li Z, Yi B, Liang C, Liu X, Li Y, He W. The change of state-trait anxiety among patients undergoing orthognathic surgery: A longitudinal study. Am J Orthod Dentofacial Orthop 2024; 165:628-637. [PMID: 38466249 DOI: 10.1016/j.ajodo.2023.12.011] [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: 01/01/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 03/12/2024]
Abstract
INTRODUCTION This study aimed to assess state-trait anxiety level changes in Chinese patients with dentofacial discrepancies before and after orthognathic surgery and to explore the feasibility of developing a reference index for the preoperative screening of postoperative patients with high anxiety. METHODS A total of 96 Chinese patients with dentofacial discrepancies who underwent orthognathic surgery were included in this study. Data were collected before orthognathic surgery and at 2 weeks (T2), 3 months, and 6 months (T4) after surgery using the State-Trait Anxiety Inventory. Receiver operating characteristic and linear regression analyses were performed to screen for preoperative indicators of postoperative high-state anxiety. RESULTS State-trait anxiety levels in patients with dentofacial discrepancies decreased after surgery (F = 18.95, P <0.01; F = 6.90, P <0.01). Trait Anxiety Inventory can be used to screen patients with high-state anxiety from T2 to T4 (area under cover 95% confidence interval: T2, 0.74 [0.62-0.86]; 3 months, 0.79 [0.69-0.90]; T4, 0.77 [0.66-0.87], P <0.01), corresponding to cutoff values of 48.5, 46.5, and 45.5, respectively. CONCLUSIONS All participants' state-trait anxiety levels improved after surgery compared with their preoperative levels. Preoperative trait anxiety levels can be used as a reference indicator to screen patients who may have high-state anxiety levels after orthognathic surgery. The creation of a screening scale will assist health care professionals to more pertinently help patients with high anxiety.
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Affiliation(s)
- Xin Yang
- Department of Oral and Maxillofacial Surgery, The affiliated Yantai Stomatological Hospital, Binzhou Medical University, Yantai, Shandong, China
| | - Xiaoxia Wang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China.
| | - Zili Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Biao Yi
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Cheng Liang
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Xiaojing Liu
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yang Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wei He
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China; National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Yu Y, Xiao W, Du LY, Li Y, Xiong C, Liang FR, Mao B, Fu JJ. Acupuncture for dyspnea and breathing physiology in chronic respiratory diseases: A systematic review and meta-analysis of randomized controlled trials. Heliyon 2024; 10:e31176. [PMID: 38813170 PMCID: PMC11133705 DOI: 10.1016/j.heliyon.2024.e31176] [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: 03/06/2023] [Revised: 05/05/2024] [Accepted: 05/12/2024] [Indexed: 05/31/2024] Open
Abstract
Background Dyspnea, a common symptom of chronic respiratory diseases (CRDs), is closely linked to higher levels of functional impairment and death, leading to significant societal and financial challenges. Despite numerous clinical trials and systematic reviews suggested the potential benefits of acupuncture for chronic obstructive pulmonary disease (COPD) and lung cancer, there is currently insufficient evidence to conclusively prove its effectiveness in alleviating dyspnea in patients with CRDs. Methods To compile and evaluate the existing data on the effectiveness and safety of acupuncture for managing dyspnea in CRDs. Randomized controlled trials investigating acupuncture for the treatment of dyspnea in patients with CRDs, such as COPD, lung cancer, asthma, bronchiectasis, interstitial lung disease, chronic pulmonary heart disease and bronchitis, were searched and retrieved from five electronic databases in English or Chinese. Results A total of 23 studies meeting the inclusion criteria were found in databases, covering various CRDs such as COPD, lung cancer, and asthma. A meta-analysis that compared acupuncture to a control group (which included no acupuncture and sham acupuncture) found significant advantages for acupuncture in reducing dyspnea severity (P = 0.0003), increasing 6MWD (P < 0.00001), improving quality of life measured by St. George's Respiratory Questionnaire (P = 0.03) and karnofsky performance status score (P < 0.00001). No significance was found in breathing physiology represented by FEV1 (P = 0.34) and FVC (P = 0.15). There was a comparable incidence of negative outcomes in both groups (P = 0.07). Results were consistent when compared to sham acupuncture. In addition, subgroup analyses were also consistent when different diseases or types of acupuncture were analyzed. Conclusions Acupuncture may be an effective and safe non-pharmacological complementary intervention to relief dyspnea for patients with CRDs. Nevertheless, research with high quality and large sample sizes is needed for further investigation.
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Affiliation(s)
- Yan Yu
- Division of Pulmonary Medicine, Department of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Wei Xiao
- Division of Pulmonary Medicine, Department of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Long-Yi Du
- Division of Pulmonary Medicine, Department of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Yu Li
- Department of Pneumology, Pidu District Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611730, PR China
| | - Chan Xiong
- Department of Pneumology, Pidu District Hospital of Traditional Chinese Medicine, The Third Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 611730, PR China
| | - Fan-Rong Liang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan 610036, PR China
| | - Bing Mao
- Division of Pulmonary Medicine, Department of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
| | - Juan-Juan Fu
- Division of Pulmonary Medicine, Department of Internal Medicine, Institute of Integrated Traditional Chinese and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China
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Schmid BC, Marsland D, Jacobs E, Rezniczek GA. A Preparatory Virtual Reality Experience Reduces Anxiety before Surgery in Gynecologic Oncology Patients: A Randomized Controlled Trial. Cancers (Basel) 2024; 16:1913. [PMID: 38791991 PMCID: PMC11119445 DOI: 10.3390/cancers16101913] [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: 04/24/2024] [Revised: 05/11/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Perioperative anxiety is common among patients undergoing surgery, potentially leading to negative outcomes. Immersive virtual reality (VR) has shown promise in reducing anxiety in various clinical settings. This study aimed to evaluate the effectiveness of VR in reducing perioperative anxiety in patients undergoing gynecological oncology surgery and was conducted as a single-center, double-arm, single-blinded randomized controlled trial at the Gold Coast University Hospital, Queensland, Australia. Participants were randomized into the VR intervention + care as usual (CAU) group (n = 39) and the CAU group (n = 41). Anxiety scores were assessed using a six-tier visual facial anxiety scale at baseline, after the intervention/CAU on the same day, and, several days up to weeks later, immediately before surgery. There was no significant difference in baseline anxiety scores, type of operation, or suspected cancer between the two groups. The VR intervention significantly reduced anxiety scores from baseline to preoperative assessment (p < 0.001). The median anxiety score in the VR intervention group decreased from 3 (interquartile range 2 to 5) at baseline to 2 (2 to 3) prior to surgery, while the control group's scores were 4 (2 to 5) and 4 (3 to 5), respectively. Multivariate analysis showed that group assignment was the sole outcome predictor, not age, type of procedure, or the time elapsed until surgery. Thus, VR exposure was effective in reducing perioperative anxiety in patients undergoing gynecological oncology surgery. The use of VR as a preparation tool may improve patient experience and contribute to better surgical outcomes, warranting further research into exploring the potential benefits of VR in other surgical specialties and its long-term impact on patient recovery.
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Affiliation(s)
- Bernd C. Schmid
- Department of Gynaecological Oncology, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD 4215, Australia
| | - Dominic Marsland
- Department of Gynaecological Oncology, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD 4215, Australia
| | - Eilish Jacobs
- Department of Gynaecological Oncology, Gold Coast University Hospital, 1 Hospital Blvd, Southport, QLD 4215, Australia
| | - Günther A. Rezniczek
- Department of Gynecology and Obstetrics, Ruhr-Universität Bochum, Marien Hospital Herne, Hölkeskampring 40, 44625 Herne, Germany
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Machado PT, Lecoultre C, Courbon C. Cross-sectional and Correlational Examination of Patients' Preoperative Anxiety, Information Need, and Health Literacy in a Presurgical Consultation. J Perianesth Nurs 2024:S1089-9472(24)00039-X. [PMID: 38762807 DOI: 10.1016/j.jopan.2024.01.020] [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: 10/19/2023] [Revised: 01/22/2024] [Accepted: 01/24/2024] [Indexed: 05/20/2024]
Abstract
PURPOSE This study elucidates the preoperative anxiety (PA), information need (IN), and health literacy (HL) levels of an elective preoperative sample in Switzerland and examines the possible associations between PA and the patients' characteristics. By knowing these patient dimensions, which can influence perioperative outcomes, one can tailor individualized nursing interventions to improve patients' surgical experience. DESIGN This was a cross-sectional and correlational study. METHODS The sample consisted of 88 patients who underwent a preoperative consultation at a Swiss tertiary hosptial. Patients' PA and IN were assessed using the Anxiety Preoperative and Information Scale, and their HL was measured using the Functional, Communicative, and Critical Health Literacy Scale. Data on other patient characteristics were collected from the patients, physicians, and electronic patient records. Association tests, as well as univariate regressions, were performed on PA, IN, HL, and patient characteristics. FINDINGS Among participants, 40.91%, 78.41%, and 59% reported having PA, IN, and low HL, respectively. Finally, PA was associated with IN, HL, solitary living, and the American Society of Anesthesiology score. CONCLUSIONS A high proportion of patients scheduled for presurgical consultation were found to be anxious. They presented high IN and low HL. An examination of patients' PA-associated characteristics can help improve their surgical experience. More studies should examine PA-associated characteristics.
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Affiliation(s)
| | - Claudia Lecoultre
- Department of Surgery and Vascular Cardiology Services, Lausanne University Hospital, Lausanne, Vaud, Switzerland
| | - Cécile Courbon
- Department of Surgery and Vascular Cardiology Services, Lausanne University Hospital, Lausanne, Vaud, Switzerland
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Xiao Y, Liu Y. Comparison of pain between bilateral ICL surgeries in patients with myopia. BMC Ophthalmol 2024; 24:175. [PMID: 38627709 PMCID: PMC11022364 DOI: 10.1186/s12886-024-03450-5] [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: 10/11/2023] [Accepted: 04/11/2024] [Indexed: 04/19/2024] Open
Abstract
PURPOSE The purpose of this study was to compare the preoperative anxiety, aqueous humor monocyte chemoattractant protein-1 (MCP-1) concentration, intraoperative pain, and degree of cooperation of the first eye implantable collamer lens (ICL) surgery with the second eye surgery, of the 1-day interval group with the 1-week interval group, and to investigate the possible causes of these differences, as well as to determine the appropriate interval between bilateral eye ICL surgeries. METHOD The study was a prospective observational study. A total of 120 patients who underwent bilateral ICL surgery at the Department of Ophthalmology, West China Fourth Hospital, Sichuan University, from July to September 2023, were enrolled. The patients were divided into a 1-day interval group and a 1-week interval group. The ICL surgery was performed on both eyes according to the schedule. Anxiety levels, aqueous humor MCP1, cooperativeness, surgical time, pain and satisfaction, and patients' estimations of the time spent in the operation were recorded for each eye. The patients were instructed to recall the intraoperative pain of the first eye surgery after the operation of the second eye. Statistical analyses (two independent samples t-test,two paired samples t-test, the rank-sum test, the chi-square test, non-parametric test with multiple independent samples) were performed to compare the differences between each score in both eyes and two groups. Furthermore, we examined the relationship between pain levels and the reproductive history of the patients. RESULTS In the 1-day interval group, male/female is 22/52, average age is 25.24±5.00. In the 1-week interval group, male/female is 17/29, average age is 25.39±5.57. There was no statistically significant difference between the two groups. In both groups, patients were less nervous, had significantly more pain, had less surgical satisfaction, had a longer estimated operative time, and had elevated preoperative MCP1 during the second eye operation. In the second eye surgery, the patient's cooperation worsened, but it did not lead to an increase in surgical time. A significant proportion of patients, particularly in the 1-week interval group, recalled experiencing reduced pain during the first eye surgery. The 1-week interval group had a higher difference in all indicators between the bilateral surgeries. In the second eye surgery, patients in the 1-week interval group experienced more severe pain, less cooperation, longer estimated operation duration, and a greater MCP1 than those in the 1-day interval group. CONCLUSION Patients undergoing second eye ICL surgery had decreased nervousness, increased pain, decreased cooperation, and satisfaction, and increased MCP1 compared to the first eye surgery. It is recommended that an interval of about one week should be avoided between bilateral surgeries when developing a surgical schedule to improve patients' cooperation, satisfaction, and comfort.
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Affiliation(s)
- Yu Xiao
- West China School of Public Health and West China Fourth Hospital,Sichuan University, Chengdu, Sichuan, China
| | - Yali Liu
- West China School of Public Health and West China Fourth Hospital,Sichuan University, Chengdu, Sichuan, China.
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Tosun F, Bülbül M, Yıldız CÇ, Özen Ö, Özerdem F. High Anxiety Levels before Elective Cesarean Section Can Negatively Affect the Mother and Fetus. Niger J Clin Pract 2024; 27:513-520. [PMID: 38679775 DOI: 10.4103/njcp.njcp_868_23] [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: 12/21/2023] [Accepted: 03/01/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Both pregnancy and surgery cause anxiety. This situation may negatively affect the health of the mother and baby. AIM The effect of anxiety level before cesarean section (CS) on feto-maternal outcomes was investigated. METHODS The preoperative anxiety score was determined with the State-Trait Anxiety Inventory (STAI) in 224 pregnant women who were planned for elective CS. RESULTS Among patients, 33.5% were in the low anxiety group, 27.2% in the moderate, and 39.3% in the high anxiety group. The average birth weight in the low anxiety group was noticeably higher than that of the high anxiety group (P = 0.018). The mean heart rate at postop 1st and 24th hour in the high anxiety group was higher than the moderate anxiety group (P < 0.028). In addition, diastolic blood pressure (DBP) at the sixth hour in the low anxiety group was found to be lower than in the moderate anxiety group (P < 0.05). CONCLUSION According to these results, it was found that an increased anxiety score before CS is associated with low birth weight in the baby, higher heart rate, and DBP in the mother.
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Affiliation(s)
- F Tosun
- Department of Anesthesia and Reanimation, Adiyaman University Faculty of Medicine, Adiyaman, Turkey
| | - M Bülbül
- Department of Obstetrics and Gynecology, Karabuk University Faculty of Medicine, Karabuk, Turkey
| | - C Ç Yıldız
- Department of Anesthesia and Reanimation, Adiyaman University Faculty of Medicine, Adiyaman, Turkey
| | - Ö Özen
- Department of Anesthesia and Reanimation, Adiyaman University Faculty of Medicine, Adiyaman, Turkey
| | - F Özerdem
- Department of Anesthesia and Reanimation, Adiyaman University Faculty of Medicine, Adiyaman, Turkey
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Cunningham NR, Adler MA, Barber Garcia BN, Abounader T, Miller AK, Monzalvo M, Hashemi I, Cox R, Ely SL, Zhou Y, DeLano M, Mulderink T, Reeves MJ, Peugh JL, Kashikar-Zuck S, Coghill RC, Arnetz JE, Zhu DC. Study protocol for a pilot clinical trial to understand neural mechanisms of response to a psychological treatment for pain and anxiety in pediatric functional abdominal pain disorders (FAPD). PLoS One 2024; 19:e0299170. [PMID: 38498587 PMCID: PMC10947640 DOI: 10.1371/journal.pone.0299170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Accepted: 02/23/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Functional abdominal pain disorders (FAPD) are the most common chronic pain conditions of childhood and are made worse by co-occurring anxiety. Our research team found that the Aim to Decrease Pain and Anxiety Treatment (ADAPT), a six-session coping skills program using cognitive behavioral therapy strategies, was effective in improving pain-related symptoms and anxiety symptoms compared to standard care. In follow-up, this current randomized clinical trial (RCT) aims to test potential neural mechanisms underlying the effect of ADAPT. Specifically, this two-arm RCT will explore changes in amygdalar functional connectivity (primary outcome) following the ADAPT protocol during the water loading symptom provocation task (WL-SPT). Secondary (e.g., changes in regional cerebral blood flow via pulsed arterial spin labeling MRI) and exploratory (e.g., the association between the changes in functional connectivity and clinical symptoms) outcomes will also be investigated. METHODS We will include patients ages 11 to 16 years presenting to outpatient pediatric gastroenterology care at a midwestern children's hospital with a diagnosis of FAPD plus evidence of clinical anxiety based on a validated screening tool (the Generalized Anxiety Disorder-7 [GAD-7] measure). Eligible participants will undergo baseline neuroimaging involving the WL-SPT, and assessment of self-reported pain, anxiety, and additional symptoms, prior to being randomized to a six-week remotely delivered ADAPT program plus standard medical care or standard medical care alone (waitlist). Thereafter, subjects will complete a post assessment neuroimaging visit similar in nature to their first visit. CONCLUSIONS This small scale RCT aims to increase understanding of potential neural mechanisms of response to ADAPT. TRIAL REGISTRATION ClinicalTrials.gov registration: NCT03518216.
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Affiliation(s)
- Natoshia R. Cunningham
- Department of Family Medicine, Michigan State University, Grand Rapids, Michigan, United States of America
- College of Human Medicine, Michigan State University, Grand Rapids, Michigan State University, Grand Rapids, Michigan, United States of America
| | - Michelle A. Adler
- Department of Family Medicine, Michigan State University, Grand Rapids, Michigan, United States of America
- College of Human Medicine, Michigan State University, Grand Rapids, Michigan State University, Grand Rapids, Michigan, United States of America
| | - Brittany N. Barber Garcia
- College of Human Medicine, Michigan State University, Grand Rapids, Michigan State University, Grand Rapids, Michigan, United States of America
- Helen DeVos Children’s Hospital Pediatric Behavioral Health, Grand Rapids, Michigan, United States of America
| | - Taylor Abounader
- School of Professional Psychology, Wright State University, Dayton, Ohio, United States of America
| | - Alaina K. Miller
- School of Professional Psychology, Wright State University, Dayton, Ohio, United States of America
| | - Mariela Monzalvo
- School of Professional Psychology, Wright State University, Dayton, Ohio, United States of America
| | - Ismaeel Hashemi
- Department of Pediatric Gastroenterology, Novant Health, Wilmington, North Carolina, United States of America
| | - Ryan Cox
- College of Human Medicine, Michigan State University, Grand Rapids, Michigan State University, Grand Rapids, Michigan, United States of America
- Helen DeVos Children’s Hospital Pediatric Gastroenterology, Grand Rapids, Michigan, United States of America
| | - Samantha L. Ely
- Department of Psychiatry and Behavioral Neuroscience, Wayne State University, Detroit, Michigan, United States of America
| | - Yong Zhou
- Corewell Health Radiology, Grand Rapids, Michigan, United States of America
| | - Mark DeLano
- Corewell Health Radiology, Grand Rapids, Michigan, United States of America
- Department of Radiology, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, United States of America
| | - Todd Mulderink
- Corewell Health Radiology, Grand Rapids, Michigan, United States of America
- Department of Radiology, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, United States of America
| | - Mathew J. Reeves
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, United States of America
| | - James L. Peugh
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Susmita Kashikar-Zuck
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Robert C. Coghill
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States of America
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States of America
| | - Judith E. Arnetz
- Department of Family Medicine, Michigan State University, Grand Rapids, Michigan, United States of America
- College of Human Medicine, Michigan State University, Grand Rapids, Michigan State University, Grand Rapids, Michigan, United States of America
| | - David C. Zhu
- Department of Radiology, College of Human Medicine, Michigan State University, Grand Rapids, Michigan, United States of America
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Valls-Ontañón A, Vandepputte SS, de la Fuente C, Giralt-Hernando M, Molins-Ballabriga G, Cigarrán-Mensa M, Sabbagh A, Hernández-Alfaro F. Effectiveness of virtual reality in relieving anxiety and controlling hemodynamics during oral surgery under local anesthesia: A prospective randomized comparative study. J Craniomaxillofac Surg 2024; 52:273-278. [PMID: 38326127 DOI: 10.1016/j.jcms.2024.01.021] [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: 08/11/2023] [Revised: 10/29/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
It was the aim of the study to evaluate the contribution of a relaxing immersive experience with virtual reality (VR) goggles in reducing patient anxiety related to wisdom tooth extraction under local anesthesia. A prospective randomized comparative study in consecutive patients scheduled for bilateral wisdom tooth extraction under local anesthesia was carried out between March and December 2022. Both sides were operated upon in the same surgery, but on one side VR goggles were applied (VR), while on the other they were not (noVR). Anxiety was evaluated both subjectively (State-Trait Anxiety Inventory [STAI] and visual analogue scale [VAS]) and objectively (measuring heart rate, blood pressure [BP] and blood oxygen saturation) before (T1) and after each surgical step (T2VR and T2noVR). The study sample consisted of 27 patients: 9 men and 18 women, with an average age of 25.8 ± 6.5 years (range: 18-43). Anxiety as assessed by the STAI and VAS decreased from T1 to T2 (p < 0.001 and p < 0.001, respectively), although to a similar degree regardless of whether VR was used or not. Heart rate showed significant differences influenced by RV exposure (p = 0.013): it increased +2.5 ± 8.8 bpm in the control group and decreased -2.22 ± 7.55 bpm with VR (p = 0.013). Both minimum and maximum BP after surgery were significantly higher in the noVR group (p = 0.002 and p = 0.040, respectively). Regarding minimum BP, VR proved more effective among male patients (p = 0.057) and on starting the procedure using VR (p = 0.055). The results provided evidence of meaningful control of the hemodynamic variables, but less predictable performance in the subjective evaluation of anxiety.
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Affiliation(s)
- Adaia Valls-Ontañón
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Barcelona, Spain; Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain.
| | - Sarah Sophie Vandepputte
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | | | - Maria Giralt-Hernando
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Barcelona, Spain; Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain
| | | | | | - Ali Sabbagh
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Federico Hernández-Alfaro
- Department of Oral and Maxillofacial Surgery, Universitat Internacional de Catalunya (UIC), Barcelona, Spain; Institute of Maxillofacial Surgery, Teknon Medical Center, Barcelona, Spain
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Safy O, Rousseaux F, Faymonville ME, Libbrecht D, Fontaine R, Raaf M, Staquet C, Tasset H, Bonhomme V, Vanhaudenhuyse A, Bicego A. Virtual reality hypnosis prior to radiofrequency thermocoagulation for patients with chronic pain: an exploratory clinical trial. Front Psychol 2024; 15:1331826. [PMID: 38476394 PMCID: PMC10927839 DOI: 10.3389/fpsyg.2024.1331826] [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] [Received: 11/01/2023] [Accepted: 01/30/2024] [Indexed: 03/14/2024] Open
Abstract
Background The management of chronic pain may involve an array of tools, including radiofrequency thermocoagulation (Rf-Tc) of sensory nerve terminals. Like many other invasive procedures, Rf-Tc can generate anxiety in a lot of patients, either during the expectation of the procedure or in the course of it. Virtual reality hypnosis (VRH) is a promising tool for managing anxiety and pain in several situations, but its anxiolytic property has not been investigated in participants with chronic pain and going through a Rf-Tc procedure. Objectives The goal of this study was to evaluate the effectiveness of VRH for reducing self-assessed anxiety in participants with chronic pain, when received in preparation for Rf-Tc. Materials and methods This prospective, controlled trial was conducted in the Interdisciplinary Algology Centre of the University Hospital of Liège (Belgium). Participants were assigned to two groups: VRH or control (usual care). Assessment was carried-out at 4 time points: T0 (one week before Rf-Tc); T1 (pre-intervention, on the day of Rf-Tc); T2 (immediately after the VRH intervention outside of the Rf-Tc room); and T3 (right after Rf-Tc). Medical, sociodemographic data, anxiety trait and immersive tendencies were collected at T0. Anxiety state and pain intensity were assessed at each time points. Satisfaction was examined at T3. Results Forty-two participants were quasi-randomly assigned to the VRH or control group. No statistically significant interaction group by time was observed regarding all measured variables, including primary endpoint. However, a significant effect of time was found for anxiety and pain when considering both groups together, toward a progressive reduction. Conclusion In the context of our study, there appears to be no significant effect of VRH at reducing anxiety in participants with chronic pain undergoing Rf-Tc. Anxiety decreases along the procedure, while pain is attenuated by the local anesthetic infiltration of the Rf site. Our results suggest that the presence of a caregiver throughout the procedure might explain the progressive decrease in anxiety. Future randomized controlled trials are needed to precisely study the effectiveness of the VRH tool, and the possibility of using it as a complementary approach for anxiety during invasive procedures.
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Affiliation(s)
- Othmane Safy
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Floriane Rousseaux
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Medical Hypnosis Laboratory, MaisonNeuve-Rosemont Hospital Research Center, University of Montreal, Montreal, QC, Canada
| | - Marie-Elisabeth Faymonville
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Interdisciplinary Algology Center, University Hospital of Liège, Liège, Belgium
- Oncology Integrated Arsen Bury Center, University Hospital of Liège, Liège, Belgium
| | - Dominique Libbrecht
- Interdisciplinary Algology Center, University Hospital of Liège, Liège, Belgium
| | | | - Melissa Raaf
- Department of Anesthesia and Algology, CHC Mont Legia, Liège, Belgium
| | - Cécile Staquet
- Interdisciplinary Algology Center, University Hospital of Liège, Liège, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, Liège University, Liège, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liège University Hospital, Liège, Belgium
| | - Hadrien Tasset
- Interdisciplinary Algology Center, University Hospital of Liège, Liège, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liège University Hospital, Liège, Belgium
| | - Vincent Bonhomme
- Interdisciplinary Algology Center, University Hospital of Liège, Liège, Belgium
- Anesthesia and Perioperative Neuroscience Laboratory, GIGA-Consciousness, Liège University, Liège, Belgium
- Department of Anesthesia and Intensive Care Medicine, Liège University Hospital, Liège, Belgium
| | - Audrey Vanhaudenhuyse
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Medical Hypnosis Laboratory, MaisonNeuve-Rosemont Hospital Research Center, University of Montreal, Montreal, QC, Canada
| | - Aminata Bicego
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
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Fonseca A, Qian D, Forbes T, Li BSK, Lee C, Burdsall K, Rodriguez S, Jackson C, Wang EY, Caruso TJ. Reducing Preoperative Caregiver Anxiety With Virtual Reality: A Pragmatic, Randomized Controlled Study. J Patient Exp 2024; 11:23743735231220190. [PMID: 38188533 PMCID: PMC10771051 DOI: 10.1177/23743735231220190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024] Open
Abstract
Pediatric patients and their caregivers often experience perioperative anxiety. Interventions reduce caregiver anxiety improve cooperation and contribute to an improved patient experience. This study seeks to evaluate the efficacy of virtual reality (VR)-assisted mindfulness on perioperative caregiver anxiety. Participants were randomized into a standard of care (SOC) group, which included snacks but no technology-based distractions, or a VR group, which included snacks and a VR-guided meditation. Caregiver anxiety was measured before and after the intervention using the Visual Analogue Scale for Anxiety (VAS-A). Secondary aims explored participants' baseline anxiety with the State-Trait Anxiety Inventory (STAI). VR group participants completed a satisfaction survey. Linear regression models of VAS-A and STAI were used to compare group differences. Satisfaction survey results were reported with descriptive statistics. 26 participants were included, with 12 randomized to the SOC group and 14 to the VR group. VAS-A scores in the VR group were lower than those in the SOC group (p = .002). The STAI found no change in participants' state of anxiety in the SOC group (p = .7108), compared to a significant reduction (p = .014) in the VR group when controlling for anxiety traits. 12 of 14 caregivers in the VR group expressed satisfaction or strong satisfaction. This study supports the implementation of VR mindfulness as a method to reduce caregiver anxiety. VR use in the pediatric healthcare setting is safe and inexpensive, and the intervention had a high degree of participant satisfaction.
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Affiliation(s)
- Ahtziri Fonseca
- Chariot Program, Stanford Children's Health, Palo Alto, CA, USA
| | - Daniel Qian
- Division of Pediatric Anesthesia, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ty Forbes
- Division of Pediatric Anesthesia, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
- University of Texas McGovern Medical School, Houston, TX, USA
| | - Brian S-K Li
- Division of Pediatric Anesthesia, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
- Department of Comparative Literature, Princeton University, Princeton, NJ, USA
| | - Charles Lee
- Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Kylie Burdsall
- Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Samuel Rodriguez
- Division of Pediatric Anesthesia, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Christian Jackson
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Ellen Y Wang
- Division of Pediatric Anesthesia, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
| | - Thomas J Caruso
- Division of Pediatric Anesthesia, Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford University, Palo Alto, CA, USA
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Mohsenpour M, Ebadi A, Mousavi B, Repišti S, Sharif Nia H, Ghanei Gheshlagh R. Psychometric Evaluation of the Farsi Version of the Surgical Anxiety Questionnaire. J Perianesth Nurs 2023; 38:907-911. [PMID: 37665300 DOI: 10.1016/j.jopan.2023.03.003] [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: 10/16/2022] [Revised: 03/04/2023] [Accepted: 03/11/2023] [Indexed: 09/05/2023]
Abstract
PURPOSE The aim of this study was to evaluate the psychometric properties of the Farsi version of the Surgical Anxiety Questionnaire. DESIGN Cross-sectional study. METHODS This study was performed on 402 patients who were candidates for elective surgery in Mashhad [East Iran) hospitals in winter 2021. After forward-backward translation, face and content validity checks were performed qualitatively. The construct validity was assessed by exploratory and confirmatory factor analysis. Data analysis was performed with SPSS 16 and AMOS 26. FINDINGS In exploratory factor analysis, two factors were extracted: concerns about surgery and anesthesia; and postdischarge concerns, which explained 52% of the total variance. The Cronbach's alpha for the entire questionnaire was 0.91 and for the subscales ranged from 0.80 to 0.87. The final model had a good fit as determined by confirmatory factor analysis. CONCLUSIONS The Farsi version of the surgical anxiety questionnaire has acceptable validity and reliability. The existence of this scale measuring domain-specific anxiety allows for further research in this area.
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Affiliation(s)
- Mohaddeseh Mohsenpour
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Bahare Mousavi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Selman Repišti
- Applied Psychology, Faculty of Applied Sciences, University of Donja Gorica (UDG), Podgorica, Montenegro
| | - Hamid Sharif Nia
- Traditional and Complementary Medicine Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Ghanei Gheshlagh
- Department of Nursing, Amol Faculty of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran.
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Srifuengfung M, Abraham J, Avidan MS, Lenze EJ. Perioperative Anxiety and Depression in Older Adults: Epidemiology and Treatment. Am J Geriatr Psychiatry 2023; 31:996-1008. [PMID: 37482501 PMCID: PMC10592367 DOI: 10.1016/j.jagp.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/20/2023] [Accepted: 07/03/2023] [Indexed: 07/25/2023]
Abstract
The intervals before and after major surgery is a high-risk period for older adults; in this setting, anxiety and depression are common and serious problems. We comprehensively reviewed current evidence on perioperative anxiety and depression in older adults, focusing on epidemiology, impact, correlates, medication risks, and treatment. Principles of perioperative mental healthcare are proposed based on the findings. Prevalence estimates of clinically significant anxiety and depression range from 5% to 45% for anxiety and 6% to 52% for depression, depending on surgical populations and measurement tools. Anxiety and depression may increase risk for surgical complications and reduce patient participation during rehabilitation. Medical comorbidities, pain, insomnia, cognitive impairment, and delirium are common co-occurring problems. Concomitant uses of central nervous system acting medications (benzodiazepines, anticholinergics, and opioids) amplify the risks of delirium and falls. Based on these findings, we propose that anxiety and depression care should be part of perioperative management in older adults; components include education, psychological support, opioid-sparing pain management, sleep management, deprescribing central nervous system active medications, and continuation and optimization of existing antidepressants. More research is needed to test and improve these care strategies.
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Affiliation(s)
- Maytinee Srifuengfung
- Department of Psychiatry (MS, EJL), Washington University School of Medicine, St. Louis, MO; Department of Psychiatry (MS), Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Joanna Abraham
- Department of Anesthesiology (JA, MSA), Washington University School of Medicine, St. Louis, MO; Institute for Informatics (JA), Washington University School of Medicine, St. Louis, MO
| | - Michael S Avidan
- Department of Anesthesiology (JA, MSA), Washington University School of Medicine, St. Louis, MO
| | - Eric J Lenze
- Department of Psychiatry (MS, EJL), Washington University School of Medicine, St. Louis, MO
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14
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Larsson CE, Cabassut V, Peretout P, Marliere S, Vautrin E, Piliero N, Salvat M, Riou L, Vanzetto G, Vilotitch A, Bosson JL, Barone-Rochette G. Assessment of the Objective Effect of Virtual Reality for Preoperative Anxiety in Interventional Cardiology. Am J Cardiol 2023; 205:207-213. [PMID: 37611412 DOI: 10.1016/j.amjcard.2023.07.130] [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: 03/29/2023] [Revised: 07/19/2023] [Accepted: 07/26/2023] [Indexed: 08/25/2023]
Abstract
The management of anxiety because of upcoming invasive coronary angiography (ICA) remains suboptimal. Previously published studies investigating the potential of virtual reality (VR) for the reduction of anxiety in ICA procedures used a subjective evaluation method. The purpose of this study was to determine whether the use of a VR program before ICA objectively decreases anxiety as assessed by the SD of normal to normal (SDNN). Lower SDNN is associated with worse anxiety. A total of 156 patients referred for ICA after a positive noninvasive test for coronary disease were included in the present randomized study. The interventional group benefited from the use of a VR mask in the transfer room before ICA, whereas the control group underwent the procedure as usual. In both groups, SDNN was measured before ICA. No statistical difference in SDNN was observed between the VR and control groups (45.5 ± 17.8 vs 50.6 ± 19.5, p = 0.12). The preoperative use of a VR mask for anxiolytic purposes in the setting of ICA did not result in a decrease in anxiety.
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Affiliation(s)
| | - Verane Cabassut
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Pauline Peretout
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Stéphanie Marliere
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Estelle Vautrin
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Nicolas Piliero
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Muriel Salvat
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France
| | - Laurent Riou
- Univ. Grenoble Alpes, Institut national de la santé et de la recherche médicale (INSERM), CHU Grenoble Alpes, LRB, 38000 Grenoble, France
| | - Gerald Vanzetto
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France; Univ. Grenoble Alpes, Institut national de la santé et de la recherche médicale (INSERM), CHU Grenoble Alpes, LRB, 38000 Grenoble, France; French Clinical Research Infrastructure Network, Paris, France
| | | | - Jean Luc Bosson
- TIMC Laboratory Centre national de la recherche scientifique (CNRS)-UMR 5525, University Grenoble Alpes, Grenoble, France; Public Health Department, CHU Grenoble Alpes, 38000, Grenoble, France
| | - Gilles Barone-Rochette
- Department of Cardiology, University Hospital, Grenoble Alpes, Grenoble, France; Univ. Grenoble Alpes, Institut national de la santé et de la recherche médicale (INSERM), CHU Grenoble Alpes, LRB, 38000 Grenoble, France; French Clinical Research Infrastructure Network, Paris, France.
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15
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Salzmann S, Euteneuer F, Kampmann S, Rienmüller S, Rüsch D. Preoperative anxiety and need for support - A qualitative analysis in 1000 patients. PATIENT EDUCATION AND COUNSELING 2023; 115:107864. [PMID: 37393683 DOI: 10.1016/j.pec.2023.107864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 06/01/2023] [Accepted: 06/19/2023] [Indexed: 07/04/2023]
Abstract
OBJECTIVES Preoperative anxiety is prevalent, emotionally distressing for many patients, and can have harmful effects on postoperative outcomes. Despite its high prevalence, there has been little research on preoperative anxiety using qualitative methods. This study's main goal was to qualitatively examine factors that may contribute to preoperative anxiety in a large sample. METHODS In a survey, a total of 1000 patients awaiting surgery were asked open questions i) about reasons which they associate with their preoperative anxiety and ii) which coping strategies they would prefer in addition to premedication. RESULTS The qualitative analysis indicated five overarching domains, 16 themes, and 54 subthemes of preoperative anxiety. Intra- or postoperative complications was the most common theme regarding preoperative anxiety (n = 516). Personal conversation was the most frequently desired supportive measure in addition to premedication. CONCLUSIONS This study indicated a considerable heterogeneity of reasons associated with preoperative anxiety based on an unbiased assessment in a large sample. The study further suggests that a personal conversation is a clinically important coping strategy in addition to premedication. PRACTICE IMPLICATIONS Providers should assess patients' preoperative anxiety and the resulting need for support individually to offer supportive measures adapted to the patients' needs.
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Affiliation(s)
- Stefan Salzmann
- Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany; Medical Psychology, Health and Medical University Erfurt, Erfurt, Germany.
| | - Frank Euteneuer
- Department of Psychology, Clinical Psychology and Psychotherapy, Medical School Berlin, Berlin, Germany
| | | | | | - Dirk Rüsch
- Philipps-University Marburg, Marburg, Germany; University Hospital Giessen-Marburg (Marburg Campus), Department of Anesthesia and Intensive Care, Marburg, Germany
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16
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Xie W, Ye F, Yan X, Cao M, Ho MH, Kwok JYY, Lee JJ. Acupressure can reduce preoperative anxiety in adults with elective surgery: A systematic review and meta-analysis of randomised controlled trials. Int J Nurs Stud 2023; 145:104531. [PMID: 37321140 DOI: 10.1016/j.ijnurstu.2023.104531] [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: 10/10/2022] [Revised: 03/28/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Preoperative anxiety is prevalent amongst adults with elective surgery and is associated with multiple detrimental perioperative physiological effects. Increasing studies support the effectiveness of acupressure in managing preoperative anxiety. However, the magnitude of acupressure's positive association with preoperative anxiety is still unclear due to a lack of rigorous evidence synthesis. OBJECTIVE To estimate the efficacy of acupressure on preoperative anxiety and physiological parameters amongst adults scheduled for elective surgery. DESIGN Systematic review and meta-analysis. DATA SOURCES Search terms were combined for acupressure and preoperative anxiety in PubMed, Cochrane Library, EMBASE, CINAHL, China National Knowledge Infrastructure, and WanFang Data Knowledge Service Platform to search for eligible randomised controlled trials from the inception of each database through September 2022. METHODS Pairs of researchers independently screened and extracted data from included studies. The risk of bias was assessed using the Cochrane risk of bias tool Version 2.0. Meanwhile, random-effects meta-analysis of overall effects and prespecified subgroup (i.e., surgery types, intervention providers, and acupressure stimulation tools) was conducted using Review Manager Software 5.4.1. Meta-regression was performed to explore study-level variables that may contribute to heterogeneity using STATA 16. RESULTS Of 24 eligible randomised controlled trials, there were a total of 2537 participants from 5 countries contributed to this synthesis. When comparing acupressure with usual care or placebo, acupressure showed a large effect size for preoperative anxiety (SMD = -1.30; 95%CI = -1.54 to -1.06; p < 0.001; I2 = 86%). The significant mean reduction of heart rate, and systolic and diastolic blood pressure was -4.58 BPM (95%CI = -6.70 to -2.46; I2 = 89%), -6.05 mmHg (95%CI = -8.73 to -3.37; p < 0.001; I2 = 88%), and -3.18 mmHg (95%CI = -5.09 to -1.27; p = 0.001; I2 = 78%), respectively. Exploratory subgroup analyses showed significant differences in surgery types and acupressure stimulation tools, whilst the intervention providers (i.e., healthcare professionals and self-administered) showed no statistically significant difference for acupressure therapy. None of the predefined participants and study-level characteristics moderated preoperative anxiety through meta-regression. CONCLUSION Acupressure appears efficacious as a therapy for improving preoperative anxiety and physiological parameters amongst adults with elective surgery. Self-administered acupressure, which is effective with a large effect, may be considered as an evidence-based approach to managing preoperative anxiety. Hence, this review aids in the development of acupressure in different types of elective surgeries and the improvement of the rigour of acupressure therapy.
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Affiliation(s)
- Wenxuan Xie
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Fen Ye
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Xinyi Yan
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Mengyao Cao
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Mu-Hsing Ho
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Jojo Yan Yan Kwok
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China
| | - Jung Jae Lee
- School of Nursing, LKS Faculty of Medicine, University of Hong Kong, China.
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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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18
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Wadhwa A, Akash VS, Bharadwaj S, Kadarapura NG, Konar SK, Naik S, Sriganesh K, Venkataramaiah S. Association between patient characteristics and dissatisfaction after cranial neurosurgery: A prospective observational study. J Neurosci Rural Pract 2023; 14:280-285. [PMID: 37181196 PMCID: PMC10174114 DOI: 10.25259/jnrp_31_2023] [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: 01/15/2023] [Accepted: 02/01/2023] [Indexed: 03/08/2023] Open
Abstract
Objectives Patient satisfaction is an indicator of the quality of healthcare. It can improve treatment adherence and health outcomes. This study aimed to determine the incidence, predictive factors, and impact of post-operative patient dissatisfaction with perioperative care after cranial neurosurgery. Materials and Methods This was a prospective observational study conducted in a tertiary care academic university hospital. Adult patients undergoing cranial neurosurgery were assessed for satisfaction 24 h after surgery using a five-point scale. The data regarding patient characteristics that may predict dissatisfaction after surgery were collected along with ambulation time and hospital stay. Shapiro-Wilk test was used to assess normality of data. Univariate analysis was performed using Mann-Whitney U-test and significant factors were entered into binary logistic regression model for identifying predictors. The level of significance was set at P < 0.05. Results Four hundred and ninety-six adult patients undergoing cranial neurosurgery were recruited into the study from September 2021 to June 2022. Data of 390 were analyzed. The incidence of patient dissatisfaction was 20.5%. On univariate analysis, literacy, economic status, pre-operative pain, and anxiety were associated with post-operative patient dissatisfaction. On logistic regression analysis, illiteracy, higher economic status, and no pre-operative anxiety were predictors of dissatisfaction. The patient dissatisfaction did not impact ambulation time or duration of hospital stay after the surgery. Conclusion One in five patients reported dissatisfaction after cranial neurosurgery. Illiteracy, higher economic status, and no pre-operative anxiety were predictors of patient dissatisfaction. Dissatisfaction was not associated with delayed ambulation or hospital discharge.
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Affiliation(s)
- Archisha Wadhwa
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - V. S. Akash
- Department of Clinical Psychology, All India Institute of Speech and Hearing, Mysuru, Karnataka, India
| | - Suparna Bharadwaj
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - N. Gopalakrishna Kadarapura
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Subhas K. Konar
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Shweta Naik
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Kamath Sriganesh
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
| | - Sudhir Venkataramaiah
- Department of Neuroanesthesia and Neurocritical Care, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India
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Sane S, Motarjemizadeh Q, Komilzhonovich IN, Abdelbasset WK, Zaman GS, Suksatan W, Morwati S, Haki BK, Rahmani N, Golabi P, Mahmodi H. The Effect of Melatonin on Analgesia, Anxiety, and Intraocular Pressure (IOP) in Cataract Surgery Under Topical Anesthesia. J Perianesth Nurs 2023; 38:253-257. [PMID: 36323602 DOI: 10.1016/j.jopan.2022.05.081] [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: 02/14/2022] [Revised: 05/01/2022] [Accepted: 05/25/2022] [Indexed: 03/27/2023]
Abstract
PURPOSE This study investigated the effect of oral melatonin as a premedication before cataract surgery on pain score, anxiety, surgical conditions, and intraocular pressure (IOP) during cataract surgery with phacoemulsification under topical anesthesia. DESIGN This randomized, double-blind prospective study was conducted among 120 patients aged 50 to 80. METHODS Patients were randomly assigned to receive either sublingual melatonin 3 mg or placebo 60 min before surgery. Verbal anxiety and pain scores, heart rate, systolic and diastolic blood pressure, intraocular pressure, and quality of surgical conditions were recorded. The results were analyzed using SPSS 23 software, and statistical analysis consisted of χ2 test and t-test, and a P value less than .05 was considered significant. FINDINGS There was a significant difference between the two groups regarding pain after the surgery before being discharged from the recovery room. The mean pain score in the melatonin group was lower than the placebo group in T4 (in the postoperative ward) (P < .05). The anxiety score of patients was lower in the melatonin group in T3 and T4 (during surgery and in the postoperative ward, respectively) (P < .05). IOP was significantly lower in the case group at the end of the surgery after receiving premedication (P = .021). CONCLUSIONS This study showed that 3 mg Sublingual melatonin premedication for patients undergoing cataract surgery under topical anesthesia reduced patients' anxiety scores, pain score, and IOP.
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Affiliation(s)
- Shahryar Sane
- Department of Anesthesiology, Urmia Imam Khomeini Hospital, Urmia University of Medical Science, Urmia, Iran
| | - Qader Motarjemizadeh
- Department of Ophthalmology, Urmia Imam Khomeini Hospital, Urmia University of Medical Science, Urmia, Iran
| | | | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al Kharj, Saudi Arabia
| | - Gaffar Sarwar Zaman
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Wanich Suksatan
- Faculty of Nursing, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Shabnam Morwati
- Faculty of Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behzad Kazemi Haki
- Department of Anesthesiology, Urmia Imam Khomeini Hospital, Urmia University of Medical Science, Urmia, Iran
| | - Nazila Rahmani
- College of Medical, Veterinary & Life Science, University of Glasgow, Glasgow, United Kingdom
| | - Parang Golabi
- Department of Anesthesiology, Omid Charity Hospital, Urmia University of Medical Science, Urmia, Iran.
| | - Hamed Mahmodi
- Department of Medicine, Urmia University of Medical Science, Urmia, Iran
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20
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Hou H, Li X, Song Y, Ji Y, Sun M, Wang D, Jiao J, Qu J, Gu H. Effect of interactive, multimedia-based home-initiated education on preoperative anxiety inchildren and their parents: a single-center randomized controlled trial. BMC Anesthesiol 2023; 23:95. [PMID: 36977985 PMCID: PMC10045252 DOI: 10.1186/s12871-023-02055-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Anesthesiologists need to appreciate the impact of preoperative anxiety in children. The present study aimed to explore whether interactive multimedia-based home-initiated interventions could effectively relieve preoperative anxiety in pediatric patients. METHODS In this prospective study, we compared preoperative anxiety between two groups of children aged 4-9 years. Children in the control group received a question-and-answer (Q&A) introduction, and children in the intervention group received multimedia-based home-initiated preoperative education using comic booklets, videos, and coloring game books. Differences in anxiety between the two groups were evaluated by the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) at four time points: in the ophthalmology outpatient clinic before intervention as the baseline (T0); in the preoperative waiting area (T1); at the time of separating from their parents and moving to the operating room (T2); and at the time of anesthesia induction (T3). Parental anxiety was assessed by the Self-rating Anxiety Scale (SAS) and Visual Analog Scale (VAS) at T0 and T2. Other related information was collected by questionnaire. RESULTS Eighty-four children who underwent pediatric strabismus in our center between November 2020 and July 2021 were included in this study. An intention-to-treat (ITT) analysis was performed on data from 78 enrolled children. Children in the intervention group exhibited lower m-YPAS-SF scores at T1, T2, and T3 than those in the control group (all p < 0.001). By using a mixed-effect model with repeated measurement (MMRM) after adjusting the m-YPAS score at T0 as a covariate, the interventional effect in terms of themYPAS-SF score was also significant over time (p < 0.001). The percentage of children with perfect induction compliance (ICC = 0) in the intervention group was significantly higher than that in the control group [18.4% vs. 7.5%], and poor induction compliance (ICC>4) was lower (2.6% vs. 17.5%, p = 0.048). The mean parental VAS score at T2 in the intervention group was significantly lower than that in the control group (p = 0.021). CONCLUSIONS Interactive multimedia-based home-initiated intervention could reduce preoperative anxiety in children and improve the quality of anesthesia induction based on ICC scores, which may in turn impose a positive impact on parental anxiety.
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Affiliation(s)
- Huiyan Hou
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Xie Li
- Department of Ophthalmology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yun'an Song
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Yingying Ji
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Menglian Sun
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Dan Wang
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Jiali Jiao
- Institute of Translational Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China
| | - Jifang Qu
- Department of Ophthalmology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
| | - Hongbin Gu
- Department of Anesthesiology, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, P.R. China.
- Department of Anesthesiology, Fujian Children's Hospital (Fujian Branch of Shanghai Children's Medical Center), College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, P.R. China.
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21
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Mavrogiorgou P, Zogas H, Zogas G, Juckel G, Heuer JF. [Perioperative anxiety and fear of death]. DIE ANAESTHESIOLOGIE 2023; 72:266-272. [PMID: 36897352 PMCID: PMC10076359 DOI: 10.1007/s00101-023-01267-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/11/2023]
Abstract
An important field of anesthesiology but also of psychiatry and psychotherapy, is perioperative anxiety and especially the fear of death. In this review article the most important types of anxiety in the individual phases before, during and after surgery are presented and diagnostic aspects as well as risk factors are discussed. Benzodiazepines can classically be used therapeutically here, but in recent years the preoperative anxiety-reducing effects of e.g., supporting talks, acupuncture, aroma therapy, and relaxation methods have come more into focus, because benzodiazepines promote postoperative delirium, which significantly increases morbidity and mortality. Perioperative fear of death should, however, be given greater clinical and scientific attention in order not only to have a better understanding and preoperative care of patients, but also to reduce adverse consequences during surgery and afterwards.
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Affiliation(s)
- Paraskevi Mavrogiorgou
- Klinik für Psychiatrie Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum, Ruhr Universität Bochum, Alexandrinenstr. 1, 44791, Bochum, Deutschland
| | - Hannah Zogas
- Klinik für Psychiatrie Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum, Ruhr Universität Bochum, Alexandrinenstr. 1, 44791, Bochum, Deutschland.,Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie (AINS), Augusta-Kliniken Bochum, Bergstr. 26, 44791, Bochum, Deutschland
| | - Georgios Zogas
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie (AINS), Augusta-Kliniken Bochum, Bergstr. 26, 44791, Bochum, Deutschland
| | - Georg Juckel
- Klinik für Psychiatrie Psychotherapie und Präventivmedizin, LWL-Universitätsklinikum, Ruhr Universität Bochum, Alexandrinenstr. 1, 44791, Bochum, Deutschland.
| | - Jan-Florian Heuer
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie (AINS), Augusta-Kliniken Bochum, Bergstr. 26, 44791, Bochum, Deutschland
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22
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Sola C, Devigne J, Bringuier S, Pico J, Coruble L, Capdevila X, Captier G, Dadure C. Hypnosis as an alternative to general anaesthesia for paediatric superficial surgery: a randomised controlled trial. Br J Anaesth 2023; 130:314-321. [PMID: 36690538 DOI: 10.1016/j.bja.2022.11.023] [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: 08/02/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Reducing perioperative anxiety and controlling pain in children are essential to optimise recovery and outcomes for both children and their parents. By acting on sensory and affective modulation of anxiety and pain, hypnosis is widely used in medical care, especially in anaesthesia. This randomised controlled clinical trial was designed to compare general anaesthesia and intraoperative hypnosis support for perioperative management of children undergoing superficial surgery. METHODS Children aged 7-16 yr scheduled for day-case superficial surgery were included and randomly assigned to one of the following two groups: general anaesthesia group or hypnosis group. The primary outcome was length of hospital stay. Child and parent anxiety, child pain, and the occurrence of postoperative negative behavioural changes were also evaluated. RESULTS Sixty children of mean age 10.3 (standard deviation: 2.6) yr were enrolled in the study. Hypnosis was successful in all but one case. The median (25th-75th percentile) length of hospital stay was shorter in the hypnosis group (120 [95-145] vs 240.5 [218-275] min; P<0.001). The general anaesthesia group was associated with a greater incidence of high levels of preoperative anxiety in children (30 vs 11%; P=0.001) and parents (55 vs 30%; P=0.05). Pain scores did not differ between groups. No negative postoperative behavioural changes were reported. CONCLUSIONS In children aged 7-16 yr, hypnosis appears to be feasible and accepted. The quality of the perioperative experience and the rapid recovery support the use of hypnosis as an effective and safe alternative to general anaesthesia for paediatric superficial surgery. CLINICAL TRIAL REGISTRATION NCT02505880.
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Affiliation(s)
- Chrystelle Sola
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France.
| | - Julie Devigne
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France
| | - Sophie Bringuier
- Department of Anaesthesiology and Critical Care Medicine, Montpellier University Hospital, Montpellier, France
| | - Julien Pico
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Lucie Coruble
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France
| | - Xavier Capdevila
- Department of Anaesthesiology and Critical Care Medicine, Montpellier University Hospital, Montpellier, France; Montpellier Neurosciences Institute, Montpellier University Hospital, Montpellier, France
| | - Guillaume Captier
- Department of Paediatric Plastic Surgery, Montpellier University Hospital, Montpellier, France
| | - Christophe Dadure
- Department of Maternal, Child and Women's Anaesthesiology and Intensive Care Medicine, Paediatric Anaesthesia Unit, Montpellier University Hospital, Montpellier, France; Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
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23
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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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24
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Schaal NK, Hagenbeck C, Helbig M, Wulff V, Märthesheimer S, Fehm T, Hepp P. The influence of being pregnant during the COVID-19 pandemic on birth expectations and antenatal bonding. J Reprod Infant Psychol 2023; 41:15-25. [PMID: 34407711 DOI: 10.1080/02646838.2021.1962825] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
PURPOSE The aim of the present study was to compare birth expectations and antenatal bonding of women pregnant prior to and during the COVID-19 pandemic. MATERIALS AND METHODS In total, 74 pregnant women (mean age: 33.9 ± 4.1 years, gestational age: 36 ± 2 weeks) participated in the study, who were pregnant either during the the COVID-19 pandemic (corona group, N = 35, April-July 2020) or before the pandemic (control group, N = 39, October 2017-January 2019). Birth expectations were measured using the Wijma Delivery Expectancy Questionnaire (WDEQ) and Salmon's Item List (SIL) and antenatal bonding with the Maternal Antenatal Attachment Scale (MAAS). Additionally, the corona group indicated their level of worry regarding different pandemic-related aspects using visual analogue scales. RESULTS The corona group displayed significantly elevated fear of childbirth measured by the WDEQ and lower antenatal bonding quality compared to the control group. The additional items regarding COVID-19 burdens highlighted that the aspects that the partner may not be present during labour and that no visitors will be allowed in hospital were associated with the highest worries. CONCLUSIONS Midwives and gynaecologists should be aware of the negative impact of the COVID-19 pandemic on fear of childbirth and antenatal bonding .
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Affiliation(s)
- Nora K Schaal
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Carsten Hagenbeck
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Martina Helbig
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Verena Wulff
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Sarah Märthesheimer
- Department of Experimental Psychology, Heinrich-Heine-University, Düsseldorf, Germany
| | - Tanja Fehm
- Clinic for Gynecology and Obstetrics, Heinrich-Heine-University, Düsseldorf, Germany
| | - Philip Hepp
- Clinic for Gynecology and Obstetrics, University Clinic, Augsburg, Germany.,Clinic for Gynecology and Obstetrics, HELIOS University Hospital Wuppertal, University Witten/Herdecke, Wuppertal, Germany
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25
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Mavragani A, Leeuwenburgh KP, Dremmen M, van Schuppen J, Starreveld D, Dierckx B, Legerstee JS. Comparing Smartphone Virtual Reality Exposure Preparation to Care as Usual in Children Aged 6 to 14 Years Undergoing Magnetic Resonance Imaging: Protocol for a Multicenter, Observer-Blinded, Randomized Controlled Trial. JMIR Res Protoc 2023; 12:e41080. [PMID: 36692931 PMCID: PMC9906306 DOI: 10.2196/41080] [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] [Received: 07/18/2022] [Revised: 12/02/2022] [Accepted: 12/12/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND A magnetic resonance imaging (MRI) procedure can cause preprocedural and periprocedural anxiety in children. Psychosocial interventions are used to prepare children for the procedure to alleviate anxiety, but these interventions are time-consuming and costly, limiting their clinical use. Virtual reality (VR) is a promising way to overcome these limitations in the preparation of children before an MRI scan. OBJECTIVE The objective of this study is (1) to develop a VR smartphone intervention to prepare children at home for an MRI procedure; and (2) to examine the effect of the VR intervention in a randomized controlled trial, in which the VR intervention will be compared to care as usual (CAU). CAU involves an information letter about an MRI examination. The primary outcome is the child's procedural anxiety during the MRI procedure. Secondary outcomes include preprocedural anxiety and parental anxiety. We hypothesize that the VR preparation will result in a higher reduction of the periprocedural anxiety of both parents and children as compared to CAU. METHODS The VR intervention provides a highly realistic and child-friendly representation of an MRI environment. In this randomized controlled trial, 128 children (aged 6 to 14 years) undergoing an MRI scan will be randomly allocated to the VR intervention or CAU. Children in the VR intervention will receive a log-in code for the VR app and are sent cardboard VR glasses. RESULTS The VR smartphone preparation app was developed in 2020. The recruitment of participants is expected to be completed in December 2022. Data will be analyzed, and scientific papers will be submitted for publication in 2023. CONCLUSIONS The VR smartphone app is expected to significantly reduce pre- and periprocedural anxiety in pediatric patients undergoing an MRI scan. The VR app offers a realistic and child-friendly experience that can contribute to modern care. A smartphone version of the VR app has the advantage that children, and potentially their parents, can get habituated to the VR environment and noises in their own home environment and can do this VR MRI preparation as often and as long as needed. TRIAL REGISTRATION ISRCTN Registry ISRCTN20976625; https://www.isrctn.com/ISRCTN20976625. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/41080.
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Affiliation(s)
| | - Koen Pieter Leeuwenburgh
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Sophia Children's Hospital, Rotterdam, Netherlands
| | - Marjolein Dremmen
- Department of Radiology, Erasmus University Medical Center Sophia Children's Hospital, Rotterdam, Netherlands
| | - Joost van Schuppen
- Department of Radiology and Nuclear Medicine, Amsterdam University Medical Centers Emma Children's Hospital, Amsterdam, Netherlands
| | - Daniëlle Starreveld
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Sophia Children's Hospital, Rotterdam, Netherlands
| | - Bram Dierckx
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Sophia Children's Hospital, Rotterdam, Netherlands
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center Sophia Children's Hospital, Rotterdam, Netherlands
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Asiri S, Guilhermino M, Duff J. The effectiveness of using virtual reality technology for perioperative anxiety among adults undergoing elective surgery: a randomised controlled trial protocol. Trials 2022; 23:972. [PMID: 36461040 PMCID: PMC9716760 DOI: 10.1186/s13063-022-06908-3] [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] [Received: 07/18/2022] [Accepted: 11/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND More than 2.5 million people are admitted for surgery in Australia each year, and between 40 to 80% will experience moderate to high preoperative anxiety. Elevated levels of preoperative anxiety can increase the risk of postoperative complications such as pain, delayed wound healing, infection, prolonged recovery, and longer hospitalisation. Limited previous research on Virtual Reality (VR) indicates a positive impact on surgery-related anxiety and suggests that the intervention potentially leads to reduce postoperative complications. OBJECTIVE To evaluate the effectiveness of using VR technology for perioperative anxiety among adults undergoing elective surgery. METHOD A two-group parallel randomised controlled trial (RCT) will be conducted, including 150 adult patients (aged 18 years and over) undergoing elective surgery and requiring an overnight stay at a major metropolitan hospital. Eligible participants will be screened for anxiety via the Amsterdam Preoperative Anxiety and Information score (APAIS). Those with moderate to severe anxiety will be randomly allocated to receive the VR session or usual care, in the preoperative holding area. Intervention participants will use a head-mounted VR device to watch and listen to a nature scene for 10 minutes. STUDY OUTCOMES The primary outcome is perioperative anxiety measured using the visual analogue scale for anxiety (VAS-A). Secondary outcomes include stress levels (measured by saliva cortisol level and heart rate), postoperative pain, patient satisfaction with perioperative care, hospital length of stay, and VR-associated adverse events. CONCLUSION This study will help evaluate if a brief preoperative VR session can reduce perioperative anxiety for adult elective surgical patients. TRIAL REGISTRATION Australia and New Zealand Clinical Trials Registry (ANZCTR) ACTRN12620001350910.
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Affiliation(s)
- Salihah Asiri
- grid.412832.e0000 0000 9137 6644School of Nursing, Umm Al-Qura University, Makkah, Saudi Arabia ,grid.1024.70000000089150953School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia ,Australian College of Perioperative Nurses (ACORN), QLD, Australia ,grid.416100.20000 0001 0688 4634Nursing & Midwifery Research Centre, Centre for Clinical Nursing, Royal Brisbane & Women’s Hospital, Building 34, Level 5, Herston, QLD 4029 Australia
| | - Michelle Guilhermino
- grid.266842.c0000 0000 8831 109XSchool of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia ,grid.414724.00000 0004 0577 6676John Hunter Hospital – Intensive care Services, Newcastle, Australia
| | - Jed Duff
- grid.1024.70000000089150953School of Nursing, Faculty of Health, Queensland University of Technology, Brisbane, Australia ,Australian College of Perioperative Nurses (ACORN), QLD, Australia
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The Use of Therapeutic Inhaled Essential Oils (TIEO) as a Holistic Approach to Decrease Preoperative Anxiety in ERAS Gynecological Surgery. J Perianesth Nurs 2022; 37:787-794. [PMID: 35637078 DOI: 10.1016/j.jopan.2022.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/12/2022] [Accepted: 03/17/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Preoperative anxiety is a negative symptom frequently experienced by surgical patients. This evidence-based-practice (EBP) project evaluated the effectiveness of therapeutic inhaled essential oils (TIEO) on anxiety levels during the preoperative phase of surgery in enhanced recovery after surgery (ERAS) gynecological patients ages 18 to 65 years old. METHODS A prospective, preposttest, quasiexperimental design was used to evaluate preoperative anxiety scores. Patients (N = 53) scheduled for gynecological surgeries were enrolled at a level II trauma center. Upon arrival to the preoperative area on the day of surgery, patients were asked to score their anxiety level using the Visual Analog Scale for Anxiety (VAS-A). Patients were provided the TIEO intervention during their preoperative phase of surgery ranging from 15 to 60 minutes. Patients were encouraged to take mindful deep breaths and inhale the essential oil vapor. Before being transported into the operating room, patients were asked to re-evaluate their anxiety level using the VAS-A. RESULTS A matched paired t-test revealed the post-VAS-A measurements were significantly lower (n = 52, M = 31.37, SD = 24.334) than the pre-VAS-A measurements (n = 52, M = 53.50, SD = 26.863), t51 = 8.756, P = .000). On average, postanxiety scores were 22.135 mm lower than pre-anxiety scores (95% CI [17.060, 27.209]). CONCLUSIONS The use of TIEO demonstrated a statistically significant decrease in preoperative anxiety scores within the ERAS gynecological population. TIEO can be used as an adjunct intervention to manage preoperative anxiety. TIEO can be successfully administered in the preoperative area. Decreasing anxiety in the preoperative period may lead to many perioperative benefits such as improving surgical outcomes, patient satisfaction, and quality of care.
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28
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Patients’ Fears and Perceptions Associated with Anesthesia. Medicina (B Aires) 2022; 58:medicina58111577. [DOI: 10.3390/medicina58111577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/20/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Background and Objectives: It has been suggested that intense feelings of fear/anxiety and significant patient concerns may affect the perioperative course. Those findings emphasize the importance of surgical patients’ preoperative feelings. Still, current knowledge in this area is based on a limited number of studies. Thus, we think that there is a need to further explore patients’ preoperative fears, better characterize risk factors and reasons for their occurrence, and evaluate patients’ perspectives associated with anesthesia. Materials and Methods: A total of 385 patients undergoing vascular surgery were preoperatively interviewed using a questionnaire that included demographics and questions related to patients’ fears and perceptions of anesthesia. Statistical analyses included descriptive statistics, Pearson’s χ2 and McNemar tests, and multivariate ordinal logistic regression. Results: The main causes of patients’ preoperative fear were surgery (53.2%), potential complications (46.5%), and anesthesia (40%). Female sex was a predictor of surgery and anesthesia-related fear (OR = 3.07, p = 0.001; OR = 2.4, p = 0.001, respectively). Previous experience lowered the fear of current surgery (OR = 0.65, p = 0.031) and anesthesia (OR = 0.6, p = 0.017). Type of surgery, type of anesthesia, educational and socioeconomic status, and personal knowledge of an anesthesiologist affected specific anesthesia-related fears. Over 25% of patients did not know that an anesthesiologist is a physician, and only 17.7% knew where anesthesiologists work. Level of education and place of residence influenced patients’ perceptions of anesthesia. Conclusions: Anesthesia-related fears are affected by the type of surgery/anesthesia, experience with previous surgery, and personal knowledge of an anesthesiologist. Women, patients with lower education levels, and patients with poorer socioeconomic status are at higher risk of developing those fears. The perception of anesthesiologists is inadequate, and knowledge of anesthesia is poor. Promotion of patient education regarding anesthesia is needed to alleviate those fears and increase understanding of anesthesia.
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Garcia De Avila MA, Prata RA, Jacob FLDS, Nóbrega FMDO, De Barros GR, Sugiura BMG. Educational intervention through a comic book for preoperative anxiety in children, adolescents, and their parents: A randomized clinical trial. J Pediatr Nurs 2022; 67:e208-e214. [PMID: 35871148 DOI: 10.1016/j.pedn.2022.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 07/06/2022] [Accepted: 07/08/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Reducing preoperative anxiety can help optimize surgical care. AIM To analyze the effectiveness of verbal guidance by nurses versus verbal guidance combined with a comic book on preoperative anxiety in children and their parents. METHODS We conducted a randomized parallel, two-group controlled clinical trial in the pediatric ward and a blinded anxiety assessment in the operating room of a Brazilian hospital. Individuals aged 6-14 years undergoing surgical procedures of up to 4 h for the first time were included in the study. Parents who were adults, literate, and able to communicate verbally were included. The primary outcome was the children's anxiety, measured by the Children Anxiety Questionnaire (CAQ), Visual Analog Scale (VAS), and the modified Yale Preoperative Anxiety Scale (mYPAS); the secondary outcome was the parents' anxiety, assessed by the Hamilton Anxiety Rating Scale. Participants were divided into the intervention (IG; n = 60) and control (CG; n = 60) groups. FINDINGS The two groups were homogeneous. The median age of the children was 8 years. No significant differences were observed in the CAQ and VAS scores between the two assessment time points or in the mYPAS scores between the IG and CG. However, parents' anxiety significantly decreased in both groups. APPLICATION TO PRACTICE Preoperative guidance by nurses, either verbal only or verbal information with a comic book proved beneficial in reducing parental anxiety. However, both interventions, performed on the day of surgery, failed to reduce preoperative anxiety in children and adolescents upon admission to the operating room. We recommended the process of preparing the child should begin after scheduling the surgery.
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Affiliation(s)
| | - Rafaela Aparecida Prata
- Department of Nursing, Botucatu Medical School, Universidade Estadual Paulista, Botucatu, Brazil
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Biophilic virtual reality on children's anxiety and pain during circumcision: A randomized controlled study. J Pediatr Urol 2022; 19:201-210. [PMID: 36336624 DOI: 10.1016/j.jpurol.2022.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/08/2022] [Accepted: 10/16/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION The aim of this study was to evaluate the effects of the biophilic virtual reality (BVR) method on children's pain and anxiety undergoing circumcision. MATERIALS AND METHODS This randomized controlled study used a parallel trial design guided by the CONSORT checklist. A total of 106 children were included in the analysis. Intraoperative anxiety was assessed by using the simplified Chinese version of the modified Yale Preoperative Anxiety Scale (CmYPAS), Visual Analogue Scale (VAS), heart rate (HR), and Anxiety index (Ai). Intraoperative pain was assessed by using the Faces Pain Scale-Revised (FPS-R), and Pain index (Pi). The Pearson correlation analysis was used to analyze the relationship between Ai and the CmYPAS. The primary outcomes were CmYPAS, VAS, and FPS-R, which were analyzed using the Kruskal-Wallis test. RESULTS Baseline variables were not significantly different between the BVR group (34 patients), the indoor virtual reality (IVR) group (36 patients), and the blank control group (36 patients). The CmYPAS scores during surgery were significantly lower in the BVR group and the IVR group versus the blank control group (25.0[22.9-29.2], 22.9[22.9-29.2], 33.3[33.3-38.5] respectively; P < 0.001). The VAS scores during surgery were significantly lower in the BVR group and the IVR group versus the blank control group (5.0[3.0-7.0], 3.0[2.0-5.0], 6.0[5.0-8.8] respectively; P < 0.001). The FPS-R scores during surgery were significantly lower in the BVR group and IVR group versus the blank control group (2.0[1.8-4.2], 3.0[2.0-4.8], 5.5[5.0-8.0], respectively; P < 0.001). At removal of the foreskin, Pi were significantly lower in the BVR group and IVR group versus the blank control group (6.9[4.1], 7.7[3.3], 9.8[6.2] respectively; P = 0.033). The Ai scores at each time point were significantly lower in the BVR group and IVR group versus the control (P = 0.015, P = 0.006 respectively). The correlation analysis of Ai (at removal of the foreskin) and CmYPAS scores in children showed that the Pearson correlation coefficient was 0.194 (P = 0.046). DISCUSSION This is the first RCT to investigate the effects of BVR in children undergoing circumcision. This study demonstrates a reduction in pediatric intraoperative pain and anxiety with the use of virtual reality (VR). CONCLUSION Intraoperative VR may be an effective noninvasive modality for reducing pain and anxiety during circumcision. Pi and Ai might be used to assess subjective pain and anxiety in patients.
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Xiong C, Li Y, Li CY, Liu YF, Wei H, Fu JJ. Acupuncture for dyspnea and breathing physiology in chronic respiratory diseases: A protocol of a systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore) 2022; 101:e30909. [PMID: 36253986 PMCID: PMC9575781 DOI: 10.1097/md.0000000000030909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Dyspnea is one of the most common symptoms of chronic respiratory disease (CRD) and is closely related to increased functional disability and mortality, resulting in substantial adverse outcomes on patients and imposing great social and economic burden. Although multiple clinical trials and systematic reviews have suggested that acupuncture could be effective in treating COPD and lung cancer, little is known about its effects on dyspnea relief in patients with CRD. The present study aimed to use a systematic review approach to evaluate the effectiveness and safety of acupuncture in the treatment of dyspnea in patients with CRD. METHODS We will search the following 9 databases from inception to June 30, 2022, PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, Chinese National Knowledge Infrastructure, WANFANG Database, Chinses Scientific and Technological Periodical Database, and Chinese Biomedical Database, and the Cochrane Library Database. Clinical randomized controlled trials in English or Chinese that evaluate invasive acupuncture versus control group in treatment of CRD with dyspnea will be included. The primary outcome will be dyspnea scores, breathing physiological function, and the secondary outcomes include exercise tolerance by six-minute walk distance quality of life, quality of life and adverse events. Two reviewers will independently conduct study selection, data extraction and quality assessment. The Review Manager software will be used for meta-analysis. This protocol will be carried out in accordance with the PRISMA-P guidance. CONCLUSION This systematic review and meta-analysis will provide the evidence of whether acupuncture is an effective and safe intervention for CRD with dyspnea. The results will be disseminated through peer-reviewed publication.
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Affiliation(s)
- Chan Xiong
- Department of Respiratory, No. 3 Affiliated Hospital of Chengdu University of TCM (West District), Chengdu Pidu District Hospital of TCM, Chengdu, Sichuan, China
| | - Yu Li
- Department of Respiratory, No. 3 Affiliated Hospital of Chengdu University of TCM (West District), Chengdu Pidu District Hospital of TCM, Chengdu, Sichuan, China
| | - Chen-Yi Li
- Department of Respiratory, No. 3 Affiliated Hospital of Chengdu University of TCM (West District), Chengdu Pidu District Hospital of TCM, Chengdu, Sichuan, China
| | - Ye-Fang Liu
- Department of Research, No. 3 Affiliated Hospital of Chengdu University of TCM (West District), Chengdu Pidu District Hospital of TCM, Chengdu, Sichuan, China
| | - Hua Wei
- Department of Respiratory, No. 3 Affiliated Hospital of Chengdu University of TCM (West District), Chengdu Pidu District Hospital of TCM, Chengdu, Sichuan, China
| | - Juan-Juan Fu
- Department of Integrated Traditional and Western Medicine, China Hospital, Sichuan University, Chengdu, Sichuan, China
- *Correspondence: Juan-juan Fu, Department of Integrated Traditional and Western Medicine, China Hospital, Sichuan University, No. 37, Guo Xue Street, Wu Hou District, Chengdu, Sichuan, China (e-mail: )
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da Cunha Lima EA, Toledo LV, Correia MDL, de Almeida Pereira D, Caetano RO, Faria TB, Braga LM. Effect of vibration associated with cryotherapy on vaccine-related pain and anxiety levels in adults: study protocol for a randomized clinical trial. Trials 2022; 23:620. [PMID: 35915477 PMCID: PMC9344641 DOI: 10.1186/s13063-022-06564-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/18/2022] [Indexed: 11/23/2022] Open
Abstract
Background Vaccination is one of the most effective strategies for prevention and eradication of immunopreventable diseases, but community acceptance of vaccination can be influenced by different factors, such as pain and anxiety. The use of high-frequency vibration associated with cryotherapy has been used to manage pain and anxiety during the vaccination process in children, but studies with adults are still scarce. This study aims to evaluate the effect of high-frequency vibration associated with cryotherapy on the levels of self-reported pain and anxiety related to administration of the Influenza vaccine intramuscularly in adults. Methods A two-arm, parallel, randomized clinical trial conducted in a Brazilian Primary Health Care Unit is proposed. A sample of 350 adults will be randomly assigned to participate in the control group, receiving the vaccine intramuscularly according to the standard protocol of the service, or in the intervention group, receiving the vaccine by the same route and using a portable device of high frequency vibration associated with cryotherapy for 30 s before and during administration. The primary endpoints will be self-reported levels of pain, assessed before and after vaccine administration. Secondary endpoints will be levels of anxiety, satisfaction with vaccine administration, and discomfort caused by high frequency vibration and temperature of the frozen bag in contact with the skin. Self-reported levels of pain and anxiety will be compared before and after vaccination as well as between the control and intervention groups. Discussion By evaluating the effect of high-frequency vibration associated with cryotherapy on pain and anxiety levels, we expect to find evidence that will support nursing practice, in order to promote greater comfort and safety in the vaccination process and, consequently, greater compliance by the population, by minimizing its undesirable effects. Trial registration Human Research Ethics Committee Opinion Number: 5.138.564. Approved on December 2, 2021. Brazilian Registry of Clinical Trials (REBEC): Registration number RBR-5zgy25w. Registered on December 09, 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06564-7.
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Affiliation(s)
| | - Luana Vieira Toledo
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | | | | | - Renata Oliveira Caetano
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Thaís Bitencourt Faria
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Luciene Muniz Braga
- Department of Medicine and Nursing, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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Lakhe G, Shrestha BB, Subedi A. Preoperative Anxiety among Patients Undergoing Elective Surgery in a Tertiary Care Centre: A Descriptive Cross-sectional Study. JNMA J Nepal Med Assoc 2022; 60:681-684. [PMID: 36705210 PMCID: PMC9446492 DOI: 10.31729/jnma.7636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/21/2022] [Indexed: 01/31/2023] Open
Abstract
Introduction Preoperative anxiety is universal in patients before surgery. It is mostly unaddressed by health professionals due to a lack of time. The objective of this study was to find out the prevalence of preoperative anxiety among patients undergoing elective surgery in a tertiary care centre. Methods A descriptive cross-sectional study was conducted on 385 surgical patients in the Department of Anaesthesia, from 27 November 2021 to 20 April 2022 in a tertiary care hospital posted for elective surgery. Ethical approval was obtained from the Institutional Review Committee (Reference number: MEMG/481/IRC). A convenience sampling was used. The level of anxiety and need for information was assessed using the Amsterdam Preoperative Anxiety and Information Scale questionnaire in a preoperative holding area. Point estimate and 95% Confidence Interval were calculated. Results Out of 385 patients posted for elective surgery, preoperative anxiety was present in 88 (22.85%) (18.66-27.04, 95% Confidence Interval) patients. The mean Amsterdam Preoperative Anxiety and Information Scale score for total anxiety and need for information was 13.59±2.47 and 5.91±3.06 respectively. Anxiety was present in 60 (68.18%) females, 45 (51.13%) young patients aged <30 years and 50 (56.81%) patients without prior experience with surgery and anaesthesia. Conclusions The prevalence of preoperative anxiety among surgical patients was lower than in previous studies done in similar settings. Preoperative anxiety was common in females, young patients and patients without previous experience with anaesthesia and surgery. Keywords anxiety; patient; preoperative; surgical.
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Affiliation(s)
- Gajal Lakhe
- Department of Anaesthesia, Manipal College of Medical Sciences, Pokhara, Nepal,Correspondence: Dr Gajal Lakhe, Department of Anesthesia, Manipal College of Medical Sciences, Pokhara, Nepal. , Phone: +977-9843742529
| | - Binod Bade Shrestha
- Department of General Surgery, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Anil Subedi
- Department of Psychiatry, Manipal College of Medical Sciences, Pokhara, Nepal
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Jenholt Nolbris M, Ragnarsson S, Brorsson AL, Garcia de Avila M, Forsner M, Kull I, Olinder AL, Mattson J, Nilsson S, Rullander AC, Rydström LL, Olaya-Contreras P, Berghammer M. Young children's voices in an unlocked Sweden during the COVID-19 pandemic. Scand J Public Health 2022; 50:693-702. [PMID: 35799462 PMCID: PMC9361420 DOI: 10.1177/14034948221108250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Aims: During the COVID-19 pandemic, Sweden was one of the few countries that
rejected lockdowns in favour of recommendations for restrictions, including
careful hand hygiene and social distancing. Preschools and primary schools
remained open. Several studies have shown negative impacts of the pandemic
on children, particularly high levels of anxiety. The study aim was to
explore how Swedish school-aged children aged 6–14 years, experienced the
COVID-19 pandemic and their perceived anxiety. Methods: In total, 774 children aged 6–14 years and their guardians answered an online
questionnaire containing 24 questions, along with two instruments measuring
anxiety: the Children’s Anxiety Questionnaire and the Numerical Rating
Scale. A convergent parallel mixed-methods design was used for analysing the
quantitative and qualitative data. Each data source was first analysed
separately, followed by a merged interpretative analysis. Results: The results showed generally low levels of anxiety, with no significant sex
differences. Children who refrained from normal social activities or group
activities (n=377) had significantly higher levels of
anxiety. Most of the children were able to appreciate the bright side of
life, despite the social distancing and refraining from activities, which
prevented them from meeting and hugging their loved ones. Conclusions: These Swedish children generally experienced low levels of anxiety,
except those who refrained from social activities. Life was nonetheless
mostly experienced as normal, largely because schools remained open.
Keeping life as normal as possible could be one important factor in
preventing higher anxiety and depression levels in children during a
pandemic.
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Affiliation(s)
- M Jenholt Nolbris
- Institute of Health and Care Sciences, University of Gothenburg, Sweden.,The Queen Silivia Children's Hospital Sahlgrenska University Hospital, Sweden
| | - S Ragnarsson
- Department of Epidemiology and Global Health, Umeå University, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | - A-L Brorsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | | | - M Forsner
- Department of Nursing, Umeå University, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Sweden
| | - I Kull
- Department of Clinical Science and Education, Karolinska Institutet, Sweden.,Sachs' Children and Youth's Hospital, Södersjukhuset, Sweden
| | - A L Olinder
- Department of Clinical Science and Education, Karolinska Institutet, Sweden.,Sachs' Children and Youth's Hospital, Södersjukhuset, Sweden
| | - J Mattson
- Department of Health Science, The Swedish Red Cross University College, Sweden.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Sweden
| | - S Nilsson
- Institute of Health and Care Sciences, University of Gothenburg, Sweden.,Centre for Person-Centred Care, University of Gothenburg, Sweden
| | | | - L-L Rydström
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | - P Olaya-Contreras
- Institute of Health and Care Sciences, University of Gothenburg, Sweden.,Centre for Person-Centred Care, University of Gothenburg, Sweden
| | - M Berghammer
- The Queen Silivia Children's Hospital Sahlgrenska University Hospital, Sweden.,Department of Health Sciences, University West, Sweden
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Afzal R, Rashid S, Khan FA. The Role of Preoperative Educational Intervention in Reducing Parental Anxiety. Cureus 2022; 14:e26548. [PMID: 35936146 PMCID: PMC9347641 DOI: 10.7759/cureus.26548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2022] [Indexed: 11/05/2022] Open
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Chen YYK, Soens MA, Kovacheva VP. Less stress, better success: a scoping review on the effects of anxiety on anesthetic and analgesic consumption. J Anesth 2022; 36:532-553. [PMID: 35779126 DOI: 10.1007/s00540-022-03081-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 05/26/2022] [Indexed: 11/29/2022]
Abstract
Preoperative anxiety has an incidence of 11-80% in patients undergoing surgical or interventional procedures. Understanding the role of preoperative anxiety on intraoperative anesthetic requirements and postoperative analgesic consumption would allow personalized anesthesia care. Over- or under-anesthetizing patients can lead to complications such as postoperative cognitive dysfunction in elderly patients, or procedural discomfort, respectively. Our scoping review focuses on the current evidence regarding the association between preoperative anxiety and intraoperative anesthetic and/or postoperative analgesic consumption in patients undergoing elective surgical or interventional procedures. Based on 44 studies that met the inclusion criteria, we found that preoperative anxiety has a significant positive correlation effect on intraoperative propofol and postoperative opioid consumption. The analysis of the literature is limited by the heterogeneity of preoperative anxiety tools used, study designs, data analyses, and outcomes. The use of shorter, validated preoperative anxiety assessment tools may help optimize the intraoperative anesthetic and postoperative analgesic regimen. Further research to determine the most feasible and clinically relevant preoperative anxiety tool and subsequent implementation has the potential to optimize perioperative care and improve patient outcomes.
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Affiliation(s)
- Yun-Yun K Chen
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America
| | - Mieke A Soens
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America
| | - Vesela P Kovacheva
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, L1,, Boston, MA, 02115, United States of America.
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Nemetski SM, Berman DI, Khine H, Fein DM. Virtual Reality as Anxiolysis During Laceration Repair in the Pediatric Emergency Department. J Emerg Med 2022; 63:72-82. [PMID: 35934650 DOI: 10.1016/j.jemermed.2022.01.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 01/14/2022] [Accepted: 01/25/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although procedural pain is effectively treated with analgesics, managing anxiety during laceration repair is more challenging. OBJECTIVES We examined the feasibility of using immersive virtual reality (VR) as anxiolysis during laceration repair in the pediatric emergency department (ED). METHODS We conducted a non-blinded, observational, pilot study in an urban pediatric ED that enrolled a convenience sample of children aged 5-13 years undergoing sutured repair of non-facial lacerations. Subjects played an immersive VR game while undergoing laceration repair. Parents assessed their child's anxiety on a 100-mm visual analogue scale at enrollment and during laceration repair. The primary outcome measure was the percentage of children whose anxiety score did not increase by ≥ 20 mm from enrollment to the first stitch. RESULTS Forty patients completed the study. Mean initial anxiety score was 54 mm (standard deviation 33 mm). Thirty-seven of forty patients (93%; 95% confidence interval [CI] 83-99%) had anxiety scores that did not increase by 20 mm or more from enrollment to the first stitch. Eighty percent (95% CI 64-91%) of patients' anxiety scores decreased between enrollment and first stitch. The mean change in anxiety score at first stitch was -39 mm (95% CI -51 mm to -27 mm; p < 0.001). Similar downward trends in anxiety scores were noted throughout the procedure. All laceration repairs were successfully completed without sedation or restraints. There were no adverse events noted, and the main barriers identified with VR use involved easily correctable technical difficulties with the equipment. CONCLUSION Immersive VR is a safe and effective distractive technique to reduce procedural anxiety during laceration repair in the pediatric ED.
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Affiliation(s)
| | - Danielle I Berman
- Department of Pediatrics, Albert Einstein College of Medicine - Children's Hospital at Montefiore, Bronx, New York
| | - Hnin Khine
- Division of Pediatric Emergency Medicine, Department of Pediatrics
| | - Daniel M Fein
- Division of Pediatric Emergency Medicine, Department of Pediatrics
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Kakar E, van Ruler O, van Straten B, Hoogteijling B, de Graaf EJR, Ista E, Lange JF, Jeekel J, Klimek M. Implementation of music in colorectal perioperative standard care-barriers and facilitators among patients and healthcare professionals. Colorectal Dis 2022; 24:868-875. [PMID: 35194930 PMCID: PMC9544166 DOI: 10.1111/codi.16102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/26/2022] [Accepted: 02/12/2022] [Indexed: 02/08/2023]
Abstract
AIM Perioperative anxiety and pain are still prevalent among patients undergoing surgery. Inflammatory bowel disease and colorectal cancer patients are known to have higher anxiety rates than the general population. Perioperatively applied music intervention has been proven to be effective in reducing perioperative anxiety and pain, resulting in a decrease of intra-operative sedative use, postoperative opioid requirement and neurohormonal stress response. IMPROVE evaluates the adherence to music intervention in colorectal perioperative standard care during systematic implementation. METHOD The Consolidated Framework for Implementation Research (CFIR) was used for implementation in three steps. This study addresses the first step in which barriers and facilitators for implementing perioperative music were identified by surveying patients who underwent colorectal surgery and healthcare professionals involved in perioperative care. Also, perioperative anxiety scores were assessed and data on perioperative pain was collected from the patients' medical records. RESULTS Fifty patients and 69 professionals (response rate 68.3%) were surveyed. For patients, all domains of the CFIR were facilitating implementation. The median reported preoperative and postoperative anxiety scores were 4.5 (1.0-7.0) and 3.0 (1.0-5.75) respectively. The median postoperative pain score on the first postoperative day was 2.8 (2.0-3.7). Also, for professionals most domains were facilitating, except for some factors related to work climate and culture among nurses. CONCLUSIONS In this study it was identified that facilitating factors for implementing music in standard perioperative care were more prominent in both patients and healthcare professionals and therefore successful implementation is probable. Also, this study provides a guideline for assessing facilitators and barriers in other settings.
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Affiliation(s)
- Ellaha Kakar
- Department of Surgery and Intensive Care UnitErasmus MCUniversity Medical CentreRotterdamThe Netherlands
| | - Oddeke van Ruler
- Department of SurgeryIJsselland HospitalCapelle aan den IJsselThe Netherlands
| | | | - Bas Hoogteijling
- Department of AnesthesiologyIJsselland HospitalCapelle aan den IJsselThe Netherlands
| | | | - Erwin Ista
- Department of Internal MedicineSection Nursing ScienceUniversity Medical CentreErasmus MCRotterdamThe Netherlands
| | - Johan F. Lange
- Department of SurgeryUniversity Medical CentreErasmus MCRotterdamThe Netherlands
| | - Johannes Jeekel
- Department of SurgeryUniversity Medical CentreErasmus MCRotterdamThe Netherlands
| | - Markus Klimek
- Department of AnesthesiologyUniversity Medical CentreErasmus MCRotterdamThe Netherlands
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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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Yagi T, Sawada K, Miyamoto M, Kinose Y, Nakagawa S, Takiuchi T, Kodama M, Kobayashi E, Hashimoto K, Mabuchi S, Tomimatsu T, Yoshino K, Kimura T. Safety and efficacy of Ninjin'yoeito along with iron supplementation therapy for preoperative anemia, fatigue, and anxiety in patients with gynecological disease: an open-label, single-center, randomized phase-II trial. BMC Womens Health 2022; 22:229. [PMID: 35701778 PMCID: PMC9195328 DOI: 10.1186/s12905-022-01824-9] [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: 10/28/2021] [Accepted: 06/06/2022] [Indexed: 11/10/2022] Open
Abstract
Background Preoperative anemia affects perioperative outcomes and often causes fatigue and psychological disorders. Therefore, anemia should be treated before a patient undergoes surgery. Ninjin’yoeito (NYT), a Japanese Kampo medicine composed of ginseng and Japanese angelica root with the other 10 herbs, is administered for anemia, fatigue and anxiety; however, there are a few reports that have prospectively examined the effects of NYT before surgery for gynecological diseases. Hence, we tended to investigate its efficacy and safety. Methods In this open-label randomized trial, women with gynecological diseases accompanied by preoperative anemia (defined as < 11.0 g/dL Hemoglobin [Hb]) were randomly assigned (1:1) into the iron supplementation and NYT groups. Patients of the iron supplementation group and the NYT group received 100 mg/day iron supplementation with and without NYT (7.5 g/day) for at least 10 days before surgery. The primary endpoint was improvement in Hb levels before and after treatment, and Cancer Fatigue Scale (CFS) and Visual Analogue Scale for Anxiety (VAS-A) scores between groups. Statistical analyses were performed with Wilcoxon signed rank test, Wilcoxon rank sum test, and Fisher’s exact test as appropriate. Results Forty patients were enrolled of whom 30 patients were finally analyzed after allocating 15 to each group. There was no difference in the characteristics between both groups. Hb significantly increased in both groups (iron supplementation group, 9.9 ± 0.8 g/dL vs. 11.9 ± 1.6 g/dL; NYT group, 9.8 ± 1.0 g/dL vs. 12.0 ± 1.0 g/dL); the difference in the elevations in Hb between both groups was statistically insignificant (P = 0.72). Contrarily, CFS (17.9 ± 10.2 vs. 8.1 ± 5.2) and VAS-A (56 mm (50–70) vs. 23 mm (6–48)) scores were significantly decreased only in the NYT group and these changes were greater in the NYT group (∆CFS, P = 0.015; ∆VAS-A, P = 0.014). Liver dysfunction occurred in one patient of the NYT group. Conclusions For treating preoperative anemia in women with gynecological conditions, NYT administration along with iron supplementation safely and efficiently improved the preoperative fatigue and anxiety in addition to the recovery from anemia. Trial registration: jRCT1051190012 (28/April/2019, retrospectively registered). Supplementary Information The online version contains supplementary material available at 10.1186/s12905-022-01824-9.
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Affiliation(s)
- Taro Yagi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan
| | - Kenjiro Sawada
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan.
| | - Mayuko Miyamoto
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan
| | - Yasuto Kinose
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan
| | - Satoshi Nakagawa
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan
| | - Tsuyoshi Takiuchi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan.,Department of Clinical Genomics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Michiko Kodama
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan
| | - Eiji Kobayashi
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan
| | - Kae Hashimoto
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan.,Department of Genetic Counseling, Osaka University Hospital, Osaka, Japan
| | - Seiji Mabuchi
- Department of Gynecologic Oncology, Osaka International Cancer Institute, Osaka, Japan
| | - Takuji Tomimatsu
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan
| | - Kiyoshi Yoshino
- Department of Obstetrics and Gynecology, University of Occupational and Environmental Health, Fukuoka, Japan
| | - Tadashi Kimura
- Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita-city, Osaka, Japan
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Fang Y, Xu Y, Cao S, Sun X, Zhang H, Jing Q, Tian L, Li C. Incidence and Risk Factors for Hypoxia in Deep Sedation of Propofol for Artificial Abortion Patients. Front Med (Lausanne) 2022; 9:763275. [PMID: 35572953 PMCID: PMC9092022 DOI: 10.3389/fmed.2022.763275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 04/04/2022] [Indexed: 11/15/2022] Open
Abstract
Background Respiratory depression is a life-threatening adverse effect of deep sedation. This study aimed to investigate the factors related to hypoxia caused by propofol during intravenous anesthesia. Methods Three hundred and eight patients who underwent painless artificial abortion in the outpatient department of Shanghai Tenth People’s Hospital between November 1, 2019 and June 30, 2020 were divided into two groups according to whether the patients experienced hypoxia (SpO2 < 95%). Preoperative anxiety assessments, anesthesia process, and operation-related information of the two groups were analyzed. The univariate analysis results were further incorporated into logistic regression analysis for multivariate analysis to determine the independent risk factors affecting hypoxia. Results Univariate analysis revealed that body mass index (BMI) (21.80 ± 2.94 vs. 21.01 ± 2.39; P = 0.038, 95% confidence interval (CI) = [−1.54, −0.04]), propofol dose (15.83 ± 3.21 vs. 14.39 ± 3.01; P = 0.002, CI = [−2.34, −0.53]), menopausal days (49.64 ± 6.03 vs. 52.14 ± 5.73; P = 0.004, CI = [0.79, 4.21]), State Anxiety Inventory score (51.19 ± 7.55 vs. 44.49 ± 8.96; P < 0.001, CI = [−9.26, −4.15]), and Self-rating Anxiety Scale score (45.86 ± 9.48 vs. 42.45 ± 9.88; P = 0.021, CI = [−6.30, −0.53]) were statistically significant risk factors for hypoxia during the operation. Logistic regression analysis showed that propofol dosage, menopausal days, and State Anxiety Inventory score were independent risk factors for hypoxia. Conclusion Patient anxiety affects the incidence of hypoxia when undergoing deep intravenous anesthesia with propofol. We can further speculate that alleviating patient anxiety can reduce the incidence of hypoxia. Clinical Trial Registration [http://www.chictr.org.cn], identifier [ChiCTR2000032167].
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Affiliation(s)
- Yiling Fang
- Department of Anesthesiology and Perioperative Medicine, School of Medicine, Shanghai Fourth People's Hospital, Tongji University, Shanghai, China.,School of Medicine, Shanghai Fourth People's Hospital, Translational Research Institute of Brain and Brain-Like Intelligence, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.,Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Department of General Practice, Zhangjiagang First People's Hospital, Affiliated to Soochow University School of Medicine, Zhangjiagang, China
| | - Yaru Xu
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Silu Cao
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoru Sun
- Department of Anesthesiology and Perioperative Medicine, School of Medicine, Shanghai Fourth People's Hospital, Tongji University, Shanghai, China.,School of Medicine, Shanghai Fourth People's Hospital, Translational Research Institute of Brain and Brain-Like Intelligence, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Hui Zhang
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qi Jing
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Tian
- Department of Anesthesiology and Perioperative Medicine, School of Medicine, Shanghai Fourth People's Hospital, Tongji University, Shanghai, China.,School of Medicine, Shanghai Fourth People's Hospital, Translational Research Institute of Brain and Brain-Like Intelligence, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Cheng Li
- Department of Anesthesiology and Perioperative Medicine, School of Medicine, Shanghai Fourth People's Hospital, Tongji University, Shanghai, China.,School of Medicine, Shanghai Fourth People's Hospital, Translational Research Institute of Brain and Brain-Like Intelligence, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
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Dziadzko M, Mazard T, Bonhomme M, Raffin M, Pradat P, Forcione JM, Minjard R, Aubrun F. Preoperative Anxiety in the Surgical Transfer and Waiting Area: A Cross-Sectional Mixed Method Study. J Clin Med 2022; 11:jcm11092668. [PMID: 35566793 PMCID: PMC9100941 DOI: 10.3390/jcm11092668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 05/04/2022] [Accepted: 05/07/2022] [Indexed: 02/04/2023] Open
Abstract
Severe preoperative anxiety (SPA) in surgical patients may have clinical consequences and worsen satisfaction. Some institutions have a surgical transfer and waiting area (TWA) for patient reception/dispatch to operating rooms. We measured the frequency of SPA, investigated predicting factors, and quantified the effect of the TWA stay on anxiety levels in a single centre cross-sectional study. Preoperative anxiety was assessed using three scales. Patients’ perceptions/suggestions were studied by a psychoanalyst. A total of 933 adult patients, undergoing elective procedures, were interviewed. SPA was detected in 24.7%, non-modified by anxiolytic premedication. Patients’ median stay was 9 min, and anxiety level was decreasing in those with SPA. In multivariable analysis, female sex, inpatient settings, and pain before the procedure were predictive for SPA. Previous operating room experience, and a supine arrival position were associated with less SPA. Patients complained about a lack of information, and an uncomfortable environment in the waiting area. To reduce anxiety, they mainly asked for warm blankets/music (physical/sound barriers), and extra sedative agents. The holding area may be a place to measure patients’ anxiety by paramedical staff, and to apply simple non-pharmacological interventions. The psychological concept of psychical envelopes may be useful for the development and investigation of such interventions in improving patients’ experience.
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Affiliation(s)
- Mikhail Dziadzko
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
- INSERM U1290 RESHAPE, Université Claude Bernard Lyon 1, 69622 Lyon, France
- Consultation Douleur, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69005 Lyon, France;
- Correspondence: ; Tel.: +33-4-2610-9325
| | - Tessa Mazard
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
| | - Myriam Bonhomme
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
| | - Mahé Raffin
- Centre de Recherche Clinique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (M.R.); (P.P.)
| | - Pierre Pradat
- Centre de Recherche Clinique, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (M.R.); (P.P.)
| | - Jean-Marc Forcione
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
| | - Raphael Minjard
- Consultation Douleur, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69005 Lyon, France;
- Centre de Recherche en Psychopathologie et Psychologie Clinique, Université Lumière Lyon-II, 69500 Bron, France
| | - Frederic Aubrun
- Département d’Anesthésie-Réanimation, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Université Claude Bernard, 69004 Lyon, France; (T.M.); (M.B.); (J.-M.F.); (F.A.)
- INSERM U1290 RESHAPE, Université Claude Bernard Lyon 1, 69622 Lyon, France
- Consultation Douleur, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69005 Lyon, France;
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Ismail TI, Mahrous RSS. Parental active participation during induction of general anesthesia to decrease children anxiety and pain. EGYPTIAN JOURNAL OF ANAESTHESIA 2022. [DOI: 10.1080/11101849.2022.2069335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Affiliation(s)
- Tarek I Ismail
- Department of Anaesthesia and Surgical Intensive Care, Helwan University, Cairo, Egypt
| | - Rabab S. S. Mahrous
- Department of Anaesthesia and Surgical Intensive Care, Alexandria University
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Jovanovic K, Kalezic N, Sipetic Grujicic S, Zivaljevic V, Jovanovic M, Kukic B, Trailovic R, Zlatanovic P, Mutavdzic P, Tomic I, Ilic N, Davidovic L. Preoperative Anxiety is Associated With Postoperative Complications in Vascular Surgery: A Cross-Sectional Study. World J Surg 2022; 46:1987-1996. [PMID: 35507076 DOI: 10.1007/s00268-022-06575-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Preoperative anxiety is associated with increased morbidity and/or mortality in surgical patients. This study investigated the incidence, predictors, and association of preoperative anxiety with postoperative complications in vascular surgery. METHODS Consecutive patients undergoing aortic, carotid, and peripheral artery surgery, under general and regional anesthesia, from February until October 2019 were included in a cross-sectional study. Anesthesiologists assessed preoperative anxiety using a validated Serbian version of the Amsterdam Preoperative Anxiety and Information Scale. Patients were divided into groups with low/high anxiety, both anesthesia- and surgery-related. Statistical analysis included multivariate linear logistic regression and point-biserial correlation. RESULTS Of 402 patients interviewed, 16 were excluded and one patient refused to participate (response rate 99.7%). Out of 385 patients included (age range 39-86 years), 62.3% had previous surgery. High-level anesthesia- and surgery-related anxieties were present in 31.2 and 43.4% of patients, respectively. Independent predictors of high-level anesthesia-related anxiety were having no children (OR = 0.443, 95% CI: 0.239-0.821, p = 0.01), personal bad experiences with anesthesia (OR = 2.294, 95% CI: 1.043-5.045, p = 0.039), and time since diagnosis for ≥ 4 months (OR = 1.634, 95% CI: 1.023-5.983, p = 0.04). The female sex independently predicted high-level surgery-related preoperative anxiety (OR = 2.387, 95% CI: 1.432-3.979, p = 0.001). High-level anesthesia-related anxiety correlated with postoperative mental disorders (rpb = 0.193, p = 0.001) and pulmonary complications (rpb = 0.104, p = 0.042). Postoperative nausea (rpb = 0.111, p = 0.03) and postoperative mental disorders (rpb = 0.160, p = 0.002) correlated with high-level surgery-related preoperative anxiety. CONCLUSIONS Since preoperative anxiety affects the postoperative course and almost every third patient experiences anxiety preoperatively, routine screening might be recommended in vascular surgery.
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Affiliation(s)
- Ksenija Jovanovic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia. .,Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
| | - Nevena Kalezic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Vladan Zivaljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Center for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Milan Jovanovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Center for Endocrine Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Biljana Kukic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia
| | - Ranko Trailovic
- Center for Anesthesiology and Resuscitation, University Clinical Center of Serbia, Pasterova 2 St, 11000, Belgrade, Serbia.,Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Petar Zlatanovic
- Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Perica Mutavdzic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Ivan Tomic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Nikola Ilic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
| | - Lazar Davidovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Clinic for Vascular and Endovascular Surgery, University Clinical Center of Serbia, Belgrade, Serbia
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Fang Y, Jing Q, Cao S, Sun X, Zhang H, Tian L, Li C. The Effect of Relaxation Therapy on Hypoxia During Intravenous Propofol Anesthesia in Patients With Pre-operative Anxiety: A Prospective Randomized Controlled Trial. Front Med (Lausanne) 2022; 9:797337. [PMID: 35372439 PMCID: PMC8965251 DOI: 10.3389/fmed.2022.797337] [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: 10/18/2021] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
Background This study aimed to investigate the effect of relaxation therapy on hypoxia during intravenous propofol anesthesia in patients with pre-operative anxiety. Methods Two-hundred and eighty patients were randomly categorized in the experimental group (relaxation therapy group) and control group. The Spielberger State-Trait Anxiety Inventory (S-STAI) was administered 30 to 60 min pre-operatively to assess the patient's current anxiety status and select appropriate patients. Patients in the experimental group received pre-surgical relaxation therapy. Decrease in oxygen saturation during the procedure was recorded for each patient group, and the relevant data were compared between the two groups. Results The basic S-STAI scores of the experimental and control groups were 56.88 ± 2.91 and 57.27 ± 3.56, respectively (p = 0.331). The difference was not statistically significant. The incidence of hypoxia in the experimental group during painless artificial abortion [routine blood oxygen saturation (SpO2) <95%, duration >15 s] decreased from 30 to 12.3%. Conclusion Relaxation therapy may effectively reduce the incidence of hypoxia during painless artificial abortion by using less dose of propofol. It may help patients relieve their anxiety and improve perioperative safety. Trial Registration Chinese Clinical Trial Registry (ChiCTR2000032109).
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Affiliation(s)
- Yiling Fang
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.,Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.,Department of General Practice, Zhangjiagang First People's Hospital, Affiliated to Soochow University School of Medicine, Suzhou, China
| | - Qi Jing
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.,Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Silu Cao
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China.,Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Xiaoru Sun
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Hui Zhang
- Department of Anesthesiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Li Tian
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
| | - Cheng Li
- Department of Anesthesiology and Perioperative Medicine, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.,Clinical Research Center for Anesthesiology and Perioperative Medicine, Tongji University, Shanghai, China
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Pahwa B, Kurwale N, Agrawal D. Evaluation of periprocedural anxiety during Gamma Knife Radiosurgery (GKRS) Frame fixation for brain lesions. Clin Neurol Neurosurg 2022; 217:107242. [DOI: 10.1016/j.clineuro.2022.107242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/14/2022] [Accepted: 04/04/2022] [Indexed: 11/15/2022]
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Euteneuer F, Kampmann S, Rienmüller S, Salzmann S, Rüsch D. Patients' desires for anxiolytic premedication - an observational study in adults undergoing elective surgery. BMC Psychiatry 2022; 22:193. [PMID: 35300643 PMCID: PMC8932104 DOI: 10.1186/s12888-022-03845-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/03/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Most patients experiencing preoperative anxiety would welcome support in coping with their anxiety. Anxiolytic medication is a common way to address preoperative anxiety. However, the proportion of patients who welcome anxiolytic medication preoperatively and the preferred time of taking it have not been studied thoroughly. METHODS Adult patients (n = 1000) scheduled to undergo elective surgery under general anesthesia were eligible to participate in this single-center observational study. Primary outcomes were the ratio of patients desiring anxiolytic medication (no/yes/on request) and the preferred time of taking it (evening before surgery/morning of day of surgery/on call to the operating room). Secondary outcomes included associations between different measures of anxiety (i.e., anxiety level according to the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and anxiety status (no/yes)) and desire for anxiolytic medication (no/yes/on request). Primary outcomes were analyzed descriptively, and secondary outcomes were analyzed using multinomial logistic regressions. RESULTS Three hundred fifty-six (35.6%) out of 1000 patients desired anxiolytic medication and 239 (23.9%) patients would welcome anxiolytic medication on request. In patients reporting anxiety (no/yes; n = 493), 228 (46.2%) stated a clear desire for anxiolytic medication (yes) and 142 (28.8%) considered anxiolytic medication (on request). Patients' preferences concerning the timing of premedication vary widely. In patients reporting a clear desire for anxiolytic medication (n = 356), the "morning of the day of surgery" was most frequently (n = 111, 31.2%) stated as the preferred time to get anxiolytic medication, followed by "on call to the operating room" (n = 51, 14.3%). All anxiety measures were significantly associated with desire for anxiolytic medication (p < 0.05). CONCLUSIONS Given the importance of preoperative anxiety to patients, patients' desire for anxiolytic medication should be considered when discussing the pros and cons of premedication. Individualized instead of standardized prescription and timing of premedication is recommended. TRIAL REGISTRATION German Clinical Trials Register ( DRKS 00013319 , approved 23/11/2017).
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Affiliation(s)
- Frank Euteneuer
- grid.10253.350000 0004 1936 9756Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstrasse 18, 35032 Marburg, Germany ,grid.466457.20000 0004 1794 7698Department of Psychology, Clinical Psychology and Psychotherapy, Medical School Berlin, Calandrellistrasse 1-9, 12247 Berlin, Germany
| | - Stefan Kampmann
- grid.10253.350000 0004 1936 9756Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany
| | - Stephen Rienmüller
- grid.10253.350000 0004 1936 9756Philipps-University Marburg, Biegenstraße 10, 35037 Marburg, Germany
| | - Stefan Salzmann
- grid.10253.350000 0004 1936 9756Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstrasse 18, 35032 Marburg, Germany
| | - Dirk Rüsch
- Philipps-University Marburg, Biegenstraße 10, 35037, Marburg, Germany. .,University Hospital Giessen-Marburg (Marburg Campus), Department of Anesthesia and Intensive Care, Baldingerstrasse, 35043, Marburg, Germany.
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Preoperative Anxiety among Adult Patients Undergoing Elective Surgeries at a Tertiary Teaching Hospital: A Cross-Sectional Study during the Era of COVID-19 Vaccination. Healthcare (Basel) 2022; 10:healthcare10030515. [PMID: 35326993 PMCID: PMC8950895 DOI: 10.3390/healthcare10030515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 02/26/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023] Open
Abstract
Anxiety in the perioperative period has significant impact on both the flow of surgery and the post-operative recovery process. The aim of this cross-sectional study is to determine the prevalence of preoperative anxiety among adult patients undergoing elective surgical procedures at a tertiary teaching hospital and the effect of COVID-19 and COVID-19 vaccines on preoperative anxiety. We used the Amsterdam Preoperative Anxiety and Information Scale (APAIS) to assess patients’ anxiety toward surgery and their need for more information. Patients with APAIS about anesthesia and surgery (APAIS-A-T) total score <10 were considered as the low preoperative anxiety group, while patients with APAIS-A-T ≥11 were considered as the high preoperative anxiety group. The overall APAIS-A-T score of the 794 included patients was 8.5 ± 4.5. The mean APAIS-A-T score was 7.0 ± 3.8 among males and 9.6 ± 4.6 among female patients (p < 0.001). The APAIS-A-T score for those who had previously underwent surgery under anesthesia was 8.3 ± 4.4, compared to 9.5 ± 4.8 for those who had not (p = 0.002). No significant difference was found between those with a previous history of COVID-19 and those without (p = 0.105), nor between those who were vaccinated and those who were not (p = 0.550). Sixty-four (26.8%) highly anxious patients were afraid of becoming infected with COVID-19 during their hospital stay (p = 0.009). This fear of COVID-19 in-hospital transmission made 19 (7.9%) highly anxious patients and 36 (4.5%) of the total sample hesitant to undergo this surgery (p = 0.002). In conclusion, this study demonstrated that 30.1% of patients had high preoperative anxiety, with fear of pain after surgery being the most common factor related to anxiety on the day of surgery. Controlling the spread of COVID-19 can play a crucial role in decreasing preoperative anxiety during this pandemic.
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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] [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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50
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Bang YJ, Lee JH, Kim CS, Lee YY, Min JJ. Anxiolytic effects of chewing gum during preoperative fasting and patient-centered outcome in female patients undergoing elective gynecologic surgery: randomized controlled study. Sci Rep 2022; 12:4165. [PMID: 35264684 PMCID: PMC8907183 DOI: 10.1038/s41598-022-07942-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 01/06/2022] [Indexed: 11/09/2022] Open
Abstract
Although previous studies reported that chewing gum during the preoperative fasting has the benefits of alleviating anxiety and dry mouth, preoperative chewing gum has yet to be accepted as a standard practice due to conventional anesthetic custom. Our study aimed to prospectively evaluate the effects of gum chewing on preoperative anxiety and patient's discomfort in female patients undergoing gynecologic surgery. Ninety-four patients were enrolled and randomized either into conventional fasting group (control group) or chewing gum with fasting group (gum group). The control group was instructed to fast from 3 p.m. on the day before surgery. The gum group performed preoperative fasting in the same manner, but was encouraged to chew gum freely during the fasting period. The primary endpoint was the degree of preoperative anxiety. For the evaluation of preoperative anxiety, Amsterdam preoperative anxiety and information scale (APAIS) was used. Preoperative gastric fluid volume and acidity were also measured as the secondary outcomes. Preoperative anxiety using APAIS was significantly lower in the gum group compared to the control group (control group vs. gum group: 20.9 vs. 17.8, p = 0.009). However, there was no significant difference in the gastric fluid analysis between the groups. In the female patients for elective gynecologic surgery, chewing gum during the preoperative fasting period helped to alleviate preoperative anxiety without additional increase of pulmonary aspiration risks.Trial registration: KCT0004422 (05/11/2019, https://cris.nih.go.kr ; registration number).
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Affiliation(s)
- Yu Jeong Bang
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Jong-Hwan Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Chung Su Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea
| | - Yoo-Young Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong-Jin Min
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
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