Effect of Sedative Premedication on Patient Experience After General Anesthesia

Maurice-Szamburski, Axel; Auquier, Pascal; Viarre-Oreal, Véronique; Cuvillon, Philippe; Carlès, Michel; Ripart, Jacques; Honoré, Stéphane; Triglia, Thibaut; Loundou, Anderson; Léone, Marc; Bruder, Nicolas

doi:10.1001/jama.2015.1108

Cited by 164 publications

(130 citation statements)

References 35 publications

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“…Moreover, after appropriate investigations, AA might be used to treat pre-operative anxiety in surgical patients, constituting serious alternative for benzodiazepines, commonly used for this purpose in clinical practice [9,10,23]. …”

Section: Resultsmentioning

confidence: 99%

Auricular Acupuncture for Exam Anxiety in Medical Students—A Randomized Crossover Investigation

et al. 2016

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Auricular acupuncture (AA) is effective in the treatment of preoperative anxiety. The aim was to investigate whether AA can reduce exam anxiety as compared to placebo and no intervention. Forty-four medical students were randomized to receive AA, placebo, or no intervention in a crossover manner and subsequently completed three comparable oral anatomy exams with an interval of 1 month between the exams/interventions. AA was applied using indwelling fixed needles bilaterally at points MA-IC1, MA-TF1, MA-SC, MA-AT1 and MA-TG one day prior to each exam. Placebo needles were used as control. Levels of anxiety were measured using a visual analogue scale before and after each intervention as well as before each exam. Additional measures included the State-Trait-Anxiety Inventory, duration of sleep at night, blood pressure, heart rate and the extent of participant blinding. All included participants finished the study. Anxiety levels were reduced after AA and placebo intervention compared to baseline and the no intervention condition (p < 0.003). AA was better at reducing anxiety than placebo in the evening before the exam (p = 0.018). Participants were able to distinguish between AA and placebo intervention. Both AA and placebo interventions reduced exam anxiety in medical students. The superiority of AA over placebo may be due to insufficient blinding of participants.

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Section: Resultsmentioning

confidence: 99%

Auricular Acupuncture for Exam Anxiety in Medical Students—A Randomized Crossover Investigation

et al. 2016

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“…Research among patients who received general anesthesia and were given lorazepam, placebo or no premedication, showed that premedication with lorazepam did not improve the experience of patients, but was associated with a longer time for extubation and a lower rate of early cognitive recovery. This research casts doubt on the routine use of lorazepam for premedication in patients undergoing general anesthesia 16. However, Scavée et al17 investigated the impact of fear and anxiety on the outcome of vascular surgery and suggested that fear and anxiety increase the incidence of postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

Analysis of perioperative pain management in vascular surgery indicates that practice does not adhere with guidelines: a retrospective cross-sectional study

Borić

Boric

et al. 2017

JPR

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BackgroundInadequate treatment of pain related to surgery may be associated with complications and prolonged recovery time and increased morbidity and mortality rates. We investigated perioperative pain management in vascular surgery and compared it with the relevant guidelines for the treatment of perioperative pain.MethodsWe conducted a retrospective study on 501 patients who underwent vascular surgery at the University Hospital Split, Croatia. We collected the following data from patients’ charts: age, gender, premedication, preoperative patient’s physical status, type of surgery, duration of surgery and anesthesia, type of anesthesia, postoperative analgesia, and need for intensive care. We examined departmental procedures to assess adherence to guidelines for perioperative pain management.ResultsNone of the 501 patients’ charts recorded information about perioperative pain intensity, 28% of patients did not receive any medication the night before their elective surgical procedures, and 17% of patients did not receive premedication immediately before the procedure. Most patients (66%) did not receive any pain medication in the operating room after surgery. Following surgery, 36% of patients were monitored in the intensive care units, while the rest were released to the ward. Some patients (17%) did not receive any analgesia after surgery. Procedures at the department did not adhere to the current recommendations for perioperative pain management.ConclusionThe study indicates that management of surgery-related pain in complex vascular procedures at this hospital did not follow guidelines for the management of acute perioperative pain. Our finding that most patients did not receive appropriate analgesia after vascular surgery leads to the conclusion that the institution would benefit from developing guidelines for the management of acute perioperative pain, which should be applied in all cases.

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“…Addressing anxiety is a serious concern for the improvement of patient experience during the perioperative period. A previous study about anxiolytic premedication failed to demonstrate any improvement in patient experience,2 suggesting that treating surgery-induced anxiety as an illness may not be the answer. Besides anxiety, a patients’ need for information is an important aspect that should be addressed because of its weight in the patient global experience of the perioperative period.…”

Section: Contextmentioning

confidence: 97%

Effect of Sedative Premedication on Patient Experience After General Anesthesia

Abstract: clinicaltrials.gov Identifier: NCT01901003.

Cited by 164 publications

References 35 publications

Auricular Acupuncture for Exam Anxiety in Medical Students—A Randomized Crossover Investigation

Auricular Acupuncture for Exam Anxiety in Medical Students—A Randomized Crossover Investigation

Analysis of perioperative pain management in vascular surgery indicates that practice does not adhere with guidelines: a retrospective cross-sectional study

Preoperative virtual reality experience may improve patient satisfaction and reduce anxiety

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