Effect of Preoperative Anxiety on Postoperative Pain and Analgesics Requirements in Patients Undergoing Abdominal Surgery_West China Medical Journal

Authors：

TANG Jianmin , YANG QingXia , NIU Minhong , LIAO Changjian , LIU Zhiheng

Shenzhen Second People’s Hospital, Shenzhen, Guangdong 518035, P. R. China;

Corresponding author：

Keywords：

腹部手术; 状态-特质焦虑量表; 视觉模拟疼痛评分; 镇痛药

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【摘要】目的 研究全身麻醉腹部手术患者术前焦虑对术后疼痛、镇痛药用量及对术后镇痛满意度的影响。方法选取2009年8月-2010年4月68例ASAⅠ～Ⅱ级，拟行气管插管全身麻醉的腹部手术患者，术前采用状态-特质焦虑量表和抑郁评分量表进行焦虑程度的测评，术后观察VAS疼痛评分、总的镇痛药用量以及患者对镇痛的满意度，分析术前焦虑与术后VAS评分、镇痛药用量及镇痛满意度的相关性。结果 68例受试者术前STAI为50±13，BDI为16±13，术后VAS评分为4.0±2.1，术后24 h镇痛药芬太尼的用量为（0.80±0.21） mg；术后镇痛药用量、患者镇痛满意度评分与术前STAI明显相关（r=0.68和r=-0.88，P lt;0.01）。术后VAS评分与术前STAI及BDI也有一定的相关（r=0.35和r=0.3）。结论术前焦虑程度可以影响腹部手术患者对镇痛治疗的满意度，显著增加镇痛药用量。
【Abstract】 Objective To investigate the effect of preoperative anxiety on postoperative pain, amount of analgesics and satisfaction of postoperative pain relief for patients undergoing abdominal surgery with general anesthesia. Methods A total of 68 patients undergoing abdominal surgery with general anesthesia from August 2009 to April 2010 were selected (ASA I-II). Preoperational anxiety levels were evaluated using State-Trait Anxiety Inventory (STAI) and Beck Depression Inventory (BDI) and postoperative VAS pain score, the total amount of analgesics used and satisfaction of pain relief were observed. The relationship between preoperative anxiety and post-operative VAS score, and total amount of analgesics used and satisfaction of pain relief were analyzed. Results The mean STAI and BDI of 68 samples were 50±13 and 16±13, respectively; the mean postoperative VAS was 4.0±2.1, and the mean amount of analgesics fentanyl used in 24 hours after the operation was (0.80±0.21) mg; the amount of post-operative analgesics used and the satisfaction of pain relief of the patients were found to be highly related to pre-operative STAI (r=0.68, -0.88; P lt;0.01). Post-operative VAS score was also related to preoperational STAI and BDI (r=0.35, 0.3). Conclusion Preoperative anxiety is closely related to the postoperative analgesics and satisfaction of pain relief for patients who had abdominal operation. Severe preoperative anxiety can significantly increase the amount of postoperative analgesics used and dissatisfaction of pain relief.

Citation： TANG Jianmin,YANG QingXia,NIU Minhong,LIAO Changjian,LIU Zhiheng. Effect of Preoperative Anxiety on Postoperative Pain and Analgesics Requirements in Patients Undergoing Abdominal Surgery. West China Medical Journal, 2010, 25(10): 1822-1824. doi: Copy

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1. Haugen AS, Eide GE, Olsen MV, et al. Anxiety in the operating theatre: a study of frequency and environmental impact in patients having local, plexus or regional anaesthesia[J]. J Clin Nurs, 2009, 18(10): 2301-2310.
2. Mitchell M. Patient anxiety and modern elective surgery: a literature review [J]. J Clin Nurs, 2003, 12(7): 806-815.
3. 周意, 李晓凡. 国内手术焦虑的研究进展[J]. 中国行为医学科学, 2003, 12(3): 119-120.
4. Cooke M, Chaboyer W, Hiratos MA. Music and its effect on anxiety in short waiting periods: a critical appraisal[J]. J Clin Nurs, 2005, 14(3): 145-155.
5. 黄琼, 赵小玉, 曾兢, 等. 围手术期患者焦虑状况及认知特点的分析[J]. 华西医学, 2009, 24(8): 2181-2182.
6. 曹伟新, 李乐之. 外科护理学[M]. 4版. 北京: 人民卫生出版社, 2006: 76.
7. Kalkman CJ, Visser K, Moen J, et al. Preoperative prediction of severe postoperative pain[J]. Pain, 2003, 105(3): 415-423.
8. 陈超, 腹腔镜与开腹胆襄切除患者术前心理状态的评估[J]. 华西医学, 2010, 25(7): 1279-1281.
9. Brown DA. Literature review exploring how healtheare profess-ionals contribute to the assessment and control of postoperative pain in older people[J]. J Clin Nurs, 2004, 13(1): 74-90.
10. Feeney SL. The relationship between pain and negative affect in older adults: anxiety as a predictor of pain[J]. J Anxiety Disord, 2004, 18(6): 733-744.
11. 倪诚, 张利萍, 李民, 等. 术前焦虑程度和术中镇静药药需要量关系的研究[J]. 中国微创外科杂志, 2007, 7(12): 1199-1202.
12. Vaughn F, Wichowski H, Bosworth G. Dose preoperative anxiety level predict postoperative pain[J]? AORN J, 2007, 85(3): 589-604.
13. Perks A, Chakravarti S, Manninen P. Preoperative anxiety in Neurosurgical patients[J]. J Neurosurg Anesthesiol, 2009, 21(2): 127-130.

West China Medical Journal

Effect of Preoperative Anxiety on Postoperative Pain and Analgesics Requirements in Patients Undergoing Abdominal Surgery

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