Preoperative Anxiety and Intraoperative Anesthetic Requirements

Maranets, Inna; Kain, Zeev N.

doi:10.1213/00000539-199912000-00003

Cited by 290 publications

(159 citation statements)

References 27 publications

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“…But the state anxiety (STAI-S), measured both in the waiting room ( Figure 2) and in the operating room just before induction (Figure 3), had no significant positive correlation with the Propofol dose requirement. This is in agreement with previous studies of Marantes et al 5 and Kil et al 6 On the other hand, heart rate (HR), which was measured in the operating room just before the induction (Figure 4), had strong positive correlation with the Propofol dose requirement for induction. We also observed that STAI-S measured in the operating room had a strong positive correlation with HR ( Figure 5).…”

Section: Discussionsupporting

confidence: 92%

“…2,3 The studies have been conducted on different hypnotic drugs from methohexitone to propofol for the purpose to test the hypothesis of whether preoperative anxiety actually increases the requirement of these hypnotic drugs. [4][5][6][7] At present Propofol is the most frequently investigated hypnotic drug and have been proved to follow the same hypothesis of higher the anxiety, higher the amount of drug required. 5,8 But some recent studies have come with different results.…”

Section: Introductionmentioning

confidence: 99%

“…[4][5][6][7] At present Propofol is the most frequently investigated hypnotic drug and have been proved to follow the same hypothesis of higher the anxiety, higher the amount of drug required. 5,8 But some recent studies have come with different results. 9,10 Anxiety and acute mental stress are associated with increased heart rate (HR) and cardiac output 11,12 and studies have shown that increased cardiac output increases the propofol requirements.…”

Section: Introductionmentioning

confidence: 99%

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Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

Hazra

Das

et al. 2017

Asian J Med Sci

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Background: Though anxiety is associated with increase in heart rate and cardiac output, there is conflicting reports regarding its effect on propofol induction dose. Aims and Objectives: The aim of the study was to delineate the correlation between pre-anesthetic anxiety and heart rate on propofol requirement for induction. Materials and Methods: Total 42 patients of ASA (American Society of Anesthesiologists) physical status I and II, 13 male and 29 female, aged between 18 to 50 years and scheduled for elective surgery under general anesthesia, were enrolled in this study. Trait anxiety in the waiting room and state anxiety both in the waiting room and operating room were assessed using Spielberger's revised State-Trait Anxiety Inventory (STAI) scale. After heart rate (HR) recording, anesthesia was induced with 200 ml/hr 1% propofol infusion till loss of verbal contact. Results: Pre-anesthetic trait anxiety and HR had strong positive correlation with propofol requirement (ρ>0.6, P<0.05) while state anxiety had not. But pre-anesthetic state anxiety measured just before induction is strongly associated with increase in HR (ρ>0.6, P<0.05).Conclusion: Pre-operative anxiety should be considered and the dose of propofol should be titrated for induction accordingly. Further, larger trials with more sophisticated monitoring are needed to confirm our findings.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

Hazra

Das

et al. 2017

Asian J Med Sci

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“…It leads to sympathetic stimulation [38], can affect anaesthetic induction [19], increases intra-and postoperative pain and analgesic requirements [39,40] and adversely affects patient satisfaction with the overall peri-operative experience [41,42]. In the present study, we chose to examine the impact of pre-operative warming on neurosurgical patients as we expected them to be more anxious than patients undergoing minor surgery.…”

Section: Discussionmentioning

confidence: 99%

The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*

2007

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SummarySkin surface warming of patients not only improves thermal comfort, but has been shown to reduce anxiety in a pre-hospital setting. We tested the hypothesis that pre-operative warming can reduce pre-operative anxiety as effectively as a conventional dose of intravenous midazolam in patients undergoing neurosurgery. We randomly allocated 80 patients to four groups in the pre-operative holding area. Treatment was applied for 30-45 min with (1) passive insulation and placebo; (2) passive insulation and intravenous midazolam (30 lg.kg )1 ); (3) warming with forced-air and placebo; and (4) warming with forced-air and intravenous midazolam (30 lg.kg )1 ). Thermal comfort levels (VAS 0-100 mm) and anxiety levels (VAS 0-100 mm, Spielberger State-Trait Anxiety Inventory) were assessed twice: before the designated treatment was started and before induction of anaesthesia. In the midazolam and the midazolam ⁄ warming groups, anxiety VAS and Spielberger state anxiety scores decreased by ) 19 (95% CI: ) 29 to ) 9, p < 0.01) and ) 10 (95% CI: ) 14 to ) 6, p < 0.01), respectively. In the warming and the combined groups, thermal VAS increased by + 26 (95% CI: 17-34, p < 0.01). [7], and prolonged hospitalisation [5]. Pre-operative warming before induction can prevent redistribution hypothermia and can improve thermal comfort by keeping the patient warm during the preoperative period [8,9]. This benefit of pre-operative warming has been demonstrated in several studies during regional [10] and general anaesthesia [8,11,12]. The administration of pre-operative warming has even been shown to abolish completely the need for any additional intra-operative warming in certain patient populations [13,14].There is, however, another potential benefit of preoperative warming: it may reduce anxiety. In four recent studies, minor trauma victims [15], patients with lower back pain [16], patients with renal colic [17] and cholelithiasis pain [18] were assigned to passive insulation or carbon-fibre warming: The warmed patients had improved thermal comfort, less pain, and were significantly less anxious.For the reduction of pre-operative anxiety, patients typically receive medications such as oral or intravenous benzodiazepines, yet these medications are not always effective and can be associated with respiratory depression and delayed discharge [19][20][21][22][23]. Thus, several non-pharmacological methods to reduce pre-operative anxiety have been considered, including music therapy [24,25], supply of in-depth information with leaflets [26] or videos

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“…Esses temores podem aumentar a quantidade de anestésico necessária durante a indução anestésica, o nível de dor pós-operatória e o tempo total de recuperação. 1,2 Sendo assim, o procedimento anestésico visa promover o conforto do paciente, reduzir as sensações desconfortáveis de dor e ansiedade, além de inconsciência, imobilidade e bloqueio de reflexos autonômicos reversíveis.…”

Section: Introductionunclassified

Assistência de enfermagem no procedimento anestésico: protocolo para segurança do paciente

Lemos¹

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Lemos CS. Assistência de enfermagem no procedimento anestésico: protocolo para segurança do paciente [dissertação]. São Paulo: Escola de Enfermagem, Universidade de São Paulo; 2015. RESUMOIntrodução: O procedimento anestésico é essencial para a realização da cirurgia, exigindo o planejamento de cuidados pela equipe cirúrgica para a segurança e a redução de danos ao paciente. No Brasil, o procedimento anestésico é privativo do anestesiologista e a equipe de enfermagem do centro cirúrgico auxilia o médico durante suas atividades, mas não há uma diretriz para execução de cuidados.Objetivos: Construir um protocolo de ações que direcione o enfermeiro durante a anestesia; avaliar, junto a anestesiologistas e enfermeiros especialistas em enfermagem perioperatória, a validade de conteúdo, a clareza dos itens, a pertinência do conteúdo e a abrangência do protocolo construído. Método: Busca na literatura de artigos publicados entre os anos de 1978 a 2014, indexados nas bases de dados Medline/Pubmed, Cinahl, Lilacs, Cochrane; Portal BVS, sobre a assistência de enfermagem em sala cirúrgica durante anestesias gerais de pacientes adultos. Elaboração de um protocolo com 40 itens, pautado na revisão elaborada, divididos em três períodos: antes da indução anestésica, indução e reversão da anestesia. O protocolo foi avaliado por 5 juízes quanto a 4 itens: validade do conteúdo, clareza, pertinência e abrangência. Cada item foi pontuado de 1 a 5, de acordo com a escala de Likert, sendo: (1) discordo totalmente, (2) discordo, (3) nem concordo/discordo, (4) concordo, (5) Elaboration of a protocol with 40 items based on the elaborated revision, and divided into three periods: before the anesthetic induction, induction, and reversal of anesthesia. The protocol was evaluated by 5 judges according to 4 items: validity of the contents, clarity, pertinence, and coverage. Each item was given scores from 1 to 5, according to the Likert scale. Namely: (1) strongly disagree, (2) disagree, (3) undecided, (4) agree, (5) strongly agree. The results were analyzed according to the content validity index (CVI). Results: The protocol was analyzed by 5 judges: 3 anesthesiologists, and 2 surgical center nurses. Before the anesthetic induction, the CVI varied from 60% to 100% in validity, 40% to 100% in clarity, 80% to 100% in pertinence, and 60% to 80% in coverage. The judges suggested changes to the items being tested and also an evaluation of the availability of materials. In the anesthetic induction, the CVI varied from 40% to 100% in validity, clarity, and content coverage, and from 20% to 100% in pertinence. The induction was the period with the most divergences between the judges, as they considered some procedures as exclusive to the anesthesiologist (ventilation assessment, venipuncture, record of vital signs). In the period of reversal of anesthesia, the validity and coverage had a CVI of 80% to 100%, with 6% to 100% for clarity and pertinence. In the reversal period, the judges suggested the monitoring of the patient for transportation, reco...

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Preoperative Anxiety and Intraoperative Anesthetic Requirements

Cited by 290 publications

References 27 publications

Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

Effect of pre-anesthetic anxiety and heart rate on propofol dose requirement for induction: A correlation study

The effect of skin surface warming on pre‐operative anxiety in neurosurgery patients*

Assistência de enfermagem no procedimento anestésico: protocolo para segurança do paciente

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