Effect of preoperative anxiety level on postoperative pain, analgesic consumption in patients undergoing laparoscopic sleeve gastrectomy: an observational cohort study
Efeito do nível de ansiedade pré-operatória na dor pós-operatória, consumo de analgésicos em pacientes submetidos à gastrectomia vertical laparoscópica: um estudo de coorte observacional
Yonca Ozvardar Pekcan, Bahattin Tuncalı, Varlık Erol
Abstract
Backgraund
: This prospective observational cohort study aimed to investigate the relationship between preoperative anxiety levels and postoperative pain and analgesic requirement in patients undergoing laparoscopic sleeve gastrectomy.
Methods
: Forty two female patients with body mass index ≥ 35, who underwent laparoscopic sleeve gastrectomy for treatment of obesity were included in the study. Spielberger's state and trait anxiety scales were used in this study. Demographic data of the patients, anesthetic and analgesic drugs during the surgery, pain levels measured with verbal analog scale at the postoperative 1st, 4th, 12th, and 24th hour, sedation levels measured with the Ramsay sedation scale, and the amount of analgesic consumed were recorded. Anesthesiologist, surgeon, and patient were not informed of the anxiety level results. The relationship between preoperative anxiety and postoperative pain and analgesic consumption was evaluated by Spearman's correlation analysis. Stepwise multiple linear regression analysis was applied. Normal Distribution control was performed by applying the Shapiro-Wilk test to residual values obtained from the final model.
Results
: There was no relationship between trait anxiety level and postoperative pain and analgesic consumption. A correlation was found between state anxiety level and pain level up to 24 hours and analgesic consumption (p < 0.05). According to the obtained model it had been observed that the university graduates consumed more analgesic compared to other education level groups.
Conclusion
: In this study, a relationship was found between preoperative state anxiety level and 24-hour pain scores and analgesic consumption in patients who underwent laparoscopic sleeve gastrectomy under general anesthesia.
Keywords
Resumo
Introdução
Este estudo de coorte observacional prospectivo teve como objetivo investigar a relação entre os níveis de ansiedade pré-operatória e a dor pós-operatória e a necessidade de analgésicos em pacientes submetidos à gastrectomia vertical laparoscópica.
Métodos
Quarenta e duas pacientes do sexo feminino com índice de massa corporal ≥ 35, submetidas à gastrectomia vertical laparoscópica para tratamento da obesidade, foram incluídas no estudo. As escalas de estado e traço de ansiedade de Spielberger foram usadas neste estudo. Dados demográficos das pacientes, drogas anestésicas e analgésicas durante a cirurgia, níveis de dor medidos com escala analógica verbal na 1ª, 4ª, 12ª e 24ª hora de pós-operatório, níveis de sedação medidos com a escala de sedação de Ramsay e a quantidade de analgésico consumido foram gravado. Anestesiologista, cirurgião e paciente não foram informados sobre os resultados do nível de ansiedade. A relação entre ansiedade pré-operatória e dor pós-operatória e consumo de analgésicos foi avaliada pela análise de correlação de Spearman. A análise de regressão linear múltipla por stepwise foi aplicada. O controle da Distribuição Normal foi realizado aplicando o teste de Shapiro-Wilk aos valores residuais obtidos do modelo final.
Resultados
Não houve relação entre nível de ansiedade-traço e dor pós-operatória e consumo de analgésicos. Encontrou-se correlação entre nível de ansiedade estado e nível de dor até 24 horas e consumo de analgésicos (p < 0,05). De acordo com o modelo obtido observou-se que os universitários consumiam mais analgésicos em comparação com outros grupos de nível de escolaridade.
Conclusão
Neste estudo, foi encontrada uma relação entre o nível de ansiedade do estado pré-operatório e os escores de dor de 24 horas e consumo de analgésicos em pacientes submetidos à gastrectomia vertical laparoscópica sob anestesia geral.
Palavras-chave
References
1 M Jawaid, A Mushtaq, S Mukhtar, et al. Preoperative anxiety before elective surgery Neurosciences (Riyadh), 12 (2007), pp. 145-148
2 A Akinsulore, A Owojuyigbe, A Faponle, et al. Assessment of preoperative and postoperative anxiety among elective major surgery patients in a tertiary hospital in Nigeria Middle East J Anaesthesiol, 23 (2015), pp. 235-240
3 M de Zwaan, J Enderle, S Wagner, et al. Anxiety and depression in bariatric surgery patients: A prospective, follow-up study using structured clinical interviews J Affect Disord, 133 (2011), pp. 61-68
4 SA Edwards-Hampton, A Madan, S Wedin, et al. A closer look at the nature of anxiety in weight loss surgery candidates Int J Psychiatry Med, 47 (2014), pp. 105-113
5 G De Cosmo, E Congedo, C Lai, et al. Preoperative psychologic and demographic predictors of pain perception and tramadol consumption using intravenous patient-controlled analgesia Clin J Pain, 24 (2008), pp. 399-405
6 LK Dunn, ME Durieux, LG Fernández, et al. Influence of catastrophizing anxiety,and depression on in-hospital opiod consumption, pain, and quality of recovery after adult spine surgery J Neurosurg Spine, 28 (2018), pp. 119-126
7 Z Ozturk Inal, U Gorkem, HA Inal Effects of preoperative anxiety on postcesarean delivery pain and analgesic consumption: general versus spinal anesthesia J Matern Fetal Neonatal Med, 33 (2020), pp. 191-197
8 ZN Kain, F Sevarino, GM Alexander, et al. Preoperative anxiety and postoperative pain in women undergoing hysterectomy. A repeated-measures design J Psychosom Res, 49 (2000), pp. 417-422
9 ZN Kain, F Sevarino, S Pincus, et al. Attenuation of the preoperative stress response with midazolam: effects on postoperative outcomes Anesthesiology, 93 (2000), pp. 141-147
10 RC Polomano, SM Heffner, DL Reck, et al. Evidence for opioid variability, Part 2: Psychosocial influences Semin Perioper Nurs, 10 (2001), pp. 159-166
11 W Caumo, MPL Hidalgo, AP Schmidt, et al. Effect of pre-operative anxiolysis on postoperative pain response in patients undergoing total abdominal hysterectomy Anaesthesia, 57 (2002), pp. 740-746
12 G Ozalp, R Sarioğlu, G Tuncel, et al. Preoperative emotional states in patients with breast canserand posoperative pain Acta Anaesthesiol Scand, 47 (2003), pp. 26-29
13 SL. Feeney The relationship between pain and negative affect in older adults: anxiety as a predictor of pain J Anxiety Disord, 18 (2004), pp. 733-744
14 M Granot, SG. Ferber The roles of pain catastrophizing and anxiety in the prediction of postoperative pain intensity: a prospective study Clin J Pain, 21 (2005), pp. 439-445
15 HYV Ip, A Abrishami, PWH Peng, et al. Predictors of postoperative pain and analgesic consumption: a qualitative systematic review Anesthesiology, 111 (2009), pp. 657-677
16 A Bayrak, G Sagiroğlu, E. Copuroglu Effects of preoperative anxiety on intraoperative hemodynamics and postoperative pain J Coll Physicians Surg Pak, 29 (2019), pp. 868-873
17 JC Kalkman, K Visser, J Moen, et al. Preoperative prediction of severe postoperative pain Pain, 105 (2003), pp. 415-423
18 K Hashimoto, S Iwayama, Y Sano, et al. Preoperative anxiety induces no clinically relevant effect on intraoperative nociceptive levels during breast surgery under general anesthesia J Anesth, 29 (2015), pp. 967-970
19 MR Munafo, J. Stevenson Selective processing of threat-related cues in day surgery patients and prediction of post-operative pain Br J Health Psychol, 8 (2003), pp. 439-449
20 ZN Kain, FB Sevarino, C Rinder, et al. Preoperative anxiolysis and postoperative recovery in women undergoing abdominal hysterectomy Anesthesiology, 94 (2001), pp. 415-422
21 Y Yılmaz, K Durmus, FY Inal, et al. The effect of preoperative and postoperative anxiety on postoperative pain and analgesic need in septoplasty operations Dicle Med J, 41 (2014) 288-29
22 GM Papageorgiou, A Papakonstantinou, E Mamplekou, et al. Pre- and postoperative psychological characteristicsin morbidly obese patients Obes Surg, 12 (2002), pp. 534-539
23 WS Kim, GJ Byeon, BJ Song, et al. Availability of preoperative anxiety scale as a predictive factor for hemodynamic changes during induction of anesthesia Korean J Anesthesiol, 58 (2010), pp. 328-333
24 N Oner, A. Le Compte State-Trait Anxiety Inventory Handbook, 1. Print Bogazici University Publications, Istanbul (1983), pp. 1-26
25 JA. Aldrete The post-anesthesia recovery score revisited J Clin Anesth, 7 (1995), pp. 89-91
26 MA Ramsay, TM Savege, BR Simpson, et al. Controlled sedation with alphaxalone-alphadolone Br Med J, 2 (1974), pp. 656-659
27 F Coluzzi, L Bragazzi, E Di Bussolo, et al. Determinants of patient satisfaction in postoperative pain management following hand ambulatory day-surgery Minerva Med, 102 (2011), pp. 177-186
28 S Karaman, S Dogru, T Karaman, et al. Anesthesia management in laparoscopic bariatric surgery: Perioperative complications and outcomes in the third year of practice JCEI, 5 (2014), pp. 200-205
29 F Vaughn, H Wichowski, G. Bosworth Does preoperative anxiety level predict postoperative pain? AORN J, 85 (2007), pp. 589-604
30 HF Rodrigues, RK Furuya, RAS Dantas, et al. Association of preoperative anxiety and depression symptoms with postoperative complications of cardiac surgeries Rev Lat Am Enfermagem, 26 (2018), p. 3107
31 A Casati, M. Putzu Anesthesia in the obese patient: pharmacokinetic considerations J Clin Anesth, 17 (2005), pp. 134-145
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email