The relation between preoperative anxiety and awareness during anesthesia: an observational study
Relação entre ansiedade pré-operatória e consciência durante a anestesia: estudo observacional
Savas Altinsoy, Ceyda Ozhan Caparlar, Jülide Ergil
Abstract
Background
Anxiety is a state of worry caused by the anticipation of external or internal danger. Awareness During Anesthesia (ADA) is an unexpected memory recall during anesthesia. In this study, we aimed to determine the factors that affect preoperative anxiety and observe the incidence of ADA, as well as to determine the anxiety levels of these patients with a history of ADA.
Methods
This study was planned to be prospective, observational, and cross-sectional. Patients in whom septoplasty was planned, who was admitted to the anesthesiology outpatients between March 2018 and September 2018, were ASA I−II, and aged 18−70 years were included in the study. The demographic characteristics of patients were recorded. The State-Trait Anxiety Inventory (STAI) was used to determine anxiety during a preoperative evaluation. The modified Brice awareness score was used simultaneously to determine previous ADA.
Results
The anxiety scores of patients who were conscious during anesthesia were higher than other patients. The mean STAI score was 40.85 ± 14.8 in the 799 patients who met the inclusion criteria of this study. When the anxiety scores were compared, the scores were higher in females than in males (p < 0.05). The mean STAI score was found as 40.3 ± 13.8 in patients who dreamed during anesthesia.
Conclusion
It is important to determine the anxiety levels of patients in the preoperative period to prevent the associated complications. Preoperative anxiety, besides preventing ADA, should be dealt with in a multidisciplinary manner. ADA should be carefully questioned while evaluating previous anesthesia experiences.
Keywords
Resumo
Justificativa
A ansiedade é um estado de preocupação causado pela expectativa de perigo externo ou interno. Consciência durante a anestesia (CDA) é a evocação imprevista da memória de eventos intranestésicos. O objetivo deste estudo foi determinar os fatores que afetam a ansiedade pré-operatória, a incidência de CDA e os níveis de ansiedade nos pacientes com antecedente de CDA.
Método
O estudo foi planificado como prospectivo, observacional e transversal. Foram incluídos no estudo pacientes programados para septoplastia eletiva, admitidos ao ambulatório de anestesiologia entre Março de 2018 e Setembro de 2018, com classe funcional ASA I−II e faixa etária entre 18 e 70 anos. As características demográficas dos pacientes foram registradas. O Inventário de Ansiedade Traço-Estado (IDATE) foi utilizado para determinar a ansiedade durante a avaliação pré-operatória. Simultaneamente, o escore de consciência de Brice modificado foi usado para determinar CDA anterior.
Resultados
Os escores de ansiedade dos pacientes que apresentaram CDA foram mais elevados do que de outros pacientes. A pontuação média do IDATE foi 40,85 ± 14,8 nos 799 pacientes que obedeceram aos critérios de inclusão do estudo. Quando os escores de ansiedade foram comparados, os escores foram maiores no sexo feminino do que no masculino (p < 0,05). O escore médio do IDATE encontrado foi 40,3 ± 13,8 nos pacientes que relataram sonhos durante a anestesia.
Conclusão
É importante determinar no pré-operatório os níveis de ansiedade dos pacientes para evitar as complicações associadas. Ansiedade pré-operatória e a prevenção de CDA devem ser tratadas com abordagem multiprofissional. A CDA deve ser cuidadosamente investigada, avaliando-se as experiências vividas pelo paciente em anestesias pregressas.
Palavras-chave
References
1 C.J. Lin, H.P. Liu, P.Y. Wang, et al. The Effectiveness of Preoperative Preparation for Improving Perioperative Outcomes in Children and Caregivers Behav Modif., 43 (2019), pp. 311-329
2 H. Aust, L. Eberhart, T. Sturm, et al. A cross-sectional study on preoperative anxiety in adults J Psychosom Res., 111 (2018), pp. 133-139
3 C.H. Kindler, C. Harms, F. Amsler, et al. The visual analog scale allows effective measurement of preoperative anxiety and detection of patients’ anesthetic concerns Anesth Analg., 90 (2000), pp. 706-712
4 A. Urfalioglu, M. Arslan, M. Bakacak, et al. Efficacy of bispectral index monitoring for prevention of anesthetic awareness and complications during oocyte pick-up procedure Turk J Med Sci., 47 (2017), pp. 1583-1589
5 D.D. Brice, R.R. Hetherington, J.E. Utting A simple study of awareness and dreaming during anaesthesia Br J Anaesth., 42 (1970), pp. 535-542
6 P.S. Sebel, T.A. Bowdle, M.M. Ghoneim, et al. The incidence of awareness during anesthesia: a multicenter United States study Anesth Analg., 99 (2004), pp. 833-839
7 R.H. Sandin, G. Enlund, P. Samuelsson, et al. Awareness during anaesthesia: a prospective case study Lancet., 355 (2000), pp. 707-711
8 N Oner, A. LeCompte Durumluk − Sürekli Kaygı Envanteri El Kitabı (1 Ed), Boğaziçi Üniversitesi Yayını, İstanbul (1983), pp. 1-26
9 AGS Aranake, A. Ben-Abdallah, N. Lin, et al. Increased risk of intraoperative awareness in patients with a history of awareness Anesthesiology., 119 (2013), pp. 1275-1283
10 AEA Tasdemir, M.N. Deniz, A. Certug Comparison of Preoperative and Postoperative Anxiety Levels with State-Trait Anxiety Inventory Test in Preoperatively Informed Patients Turk J Anaesth Reanim., 41 (2013), pp. 44-49
11 W. Caumo, A.P. Schmidt, C.N. Schneider, et al. Risk factors for preoperative anxiety in adults Acta Anaesthesiol Scand., 45 (2001), pp. 298-307
12 N. Moerman, F.S. van Dam, M.J. Muller, et al. The Amsterdam Preoperative Anxiety and Information Scale (APAIS) Anesth Analg., 82 (1996), pp. 445-451
13 M. Ghoneim The trauma of awareness: history, clinical features, risk factors, and cost Anesth Analg., 110 (2010), pp. 666-667
14 L. Grabow, R. Buse Preoperative anxiety−anxiety about the operation, anxiety about anesthesia, anxiety about pain? Psychother Psychosom Med Psychol., 40 (1990), pp. 255-263
15 R Kİ Aykent, E. Üstün, A. Tür, et al. Preoperatif anksiyete nedenleri ve değerlendirilmesi: APAİS ve STAİ Skorlarının Karşılaştırılması Türkiye Klinikleri J Anest Rean., 5 (2007), pp. 7-13
16 Ld Egbert, G Battit, H Turndorf, et al. The value of the preoperative visit by an anesthetist. A study of doctor-patient rapport JAMA., 185 (1963), pp. 553-555
17 G. Xu, X. Liu, Q. Sheng, et al. Sex differences in dreaming during short propofol sedation for upper gastrointestinal endoscopy Neuroreport., 24 (2013), pp. 797-802
18 JE. Utting The era of relaxant anaesthesia Br J Anaesth., 69 (1992), pp. 551-553
19 J.J. Pandit, J. Andrade, D.G. Bogod, et al. 5th National Audit Project (NAP5) on accidental awareness during general anaesthesia: summary of main findings and risk factors Br J Anaesth., 113 (2014), pp. 549-559
20 M. Graham, A.M. Owen, K. Cipi, et al. Minimizing the Harm of Accidental Awareness Under General Anesthesia: New Perspectives From Patients Misdiagnosed as Being in a Vegetative State Anesth Analg., 126 (2018), pp. 1073-1076
21 GA Mashour, MS. Avidan Intraoperative awareness: controversies and non-controversies Br J Anaesth., 115 (2015), pp. i20-i26
22 KBPK Domino, R.A. Caplan, F.W. Cheney Awareness during anesthesia: a closed claims analysis Anesthesiology., 90 (1999), pp. 1053-1061
23 MM. Ghoneim Awareness during anesthesia Anesthesiology., 92 (2000), pp. 597-602
24 L. Serfontein Awareness in cardiac anesthesia Curr Opin Anaesthesiol., 23 (2010), pp. 103-108
25 G. Lyons, R. Macdonald Awareness during caesarean section Anaesthesia., 46 (1991), pp. 62-64
Submitted date:
10/30/2019
Accepted date:
04/17/2020
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email