Preoperative anxiety and postoperative pain in women undergoing hysterectomy

Kain, Zeev N.; Sevarino, Ferne B.; Alexander, Gerianne M.; Pincus, Sharon; Mayes, Linda C.

doi:10.1016/s0022-3999(00)00189-6

Cited by 241 publications

(160 citation statements)

References 33 publications

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“…This decline can be explained by the patients' fast recovery and the patients' relief that surgery was over. Pre-and postoperative state anxiety were positively associated with trait anxiety, as reported previously [35]. Though frequently reported [31,36,37], no gender differences in anxiety were observed in the investigated sample.…”

Section: Discussionsupporting

confidence: 84%

“…As trait and postoperative state anxiety were positively related to the perceived medical intervention load (PMIL), strategies to reduce patients' anxiety before surgery are important to prevent detrimental effects on health and subjective wellbeing and to achieve beneficial effects for perioperative compliance, adaptation (e.g. reduced need for sedatives), and recovery [35,38,39].…”

Section: Discussionmentioning

confidence: 99%

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Comparing cardiovascular load by heart rate variability (HRV) including pNNxx parameters with ratings of perceived medical intervention load (PMIL) in patients undergoing carotid endarterectomy or carotid artery stenting

Jahn¹,

Trimmel²

2017

Surg Rehabil

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Objective: The aim was to compare subjectively experienced load with cardiovascular load in patients undergoing a medical intervention by either carotid endarterectomy (CEA) or carotid artery stenting (CAS). Heart rate variability (HRV), including parameters of the pNNxx family, and perceived medical intervention load (PMIL) were investigated and compared in a prospective study.Methods: In a sample of 52 patients (CEA: n = 28; CAS: n = 24) aged 69 ± 10 years, electrocardiogram was recorded throughout the perioperative period and questionnaires on pre-and postoperative state (STAI X1) and trait anxiety (STAI X2) as well as the PMIL were filled in. Preoperative (15 minutes before surgery) HRV parameter values of time and frequency domain were compared to postoperative values (15 minutes lasting epoch 5 hours after surgery). Results:A 2 (Time: pre vs. post) × 2 (Intervention: CEA vs. CAS) repeated measures ANOVA revealed increased HRV after CAS compared to CEA, with the most pronounced effect size for SDNN. Effect sizes for the pNNxx family around 25ms namely pNN20, pNN25, and pNN30 were also pronounced and greater than the effect size for the traditional pNN50. In both groups state anxiety was preoperatively (M = 40.03 ± 11.00) higher than postoperatively (M = 32.74 ± 7.36) but no group differences were observed for anxiety or for the subjective measure of the PMIL.Conclusion: Cardiovascular load as indicated by HRV is less for CAS compared to CEA whereas subjective measures displayed no differences. In addition, HRV assessed by pNNxx (with xx 20 -30 ms) beside global parameters like SDNN and Total Power seems to be in particular sensitive for load.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Comparing cardiovascular load by heart rate variability (HRV) including pNNxx parameters with ratings of perceived medical intervention load (PMIL) in patients undergoing carotid endarterectomy or carotid artery stenting

Jahn¹,

Trimmel²

2017

Surg Rehabil

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“…The menstrual cycle may also influence the level of descending facilitation of spinal nociceptive processing. It has long been recognized in the clinic that pain worsens when anxiety levels are increased moderately (Taenzer et al, 1986;Lautenbacher et al, 1999;Kain et al, 2000). Extreme anxiety or fear, on the other hand, elicits hypoalgesia (Ford and Finn, 2008).…”

Section: Introductionmentioning

confidence: 99%

Differential Activation of the Periaqueductal Gray by Mild Anxiogenic Stress at Different Stages of the Estrous Cycle in Female Rats

Devall¹,

Lovick²

2010

Neuropsychopharmacol

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The effect of acute exposure to mild anxiogenic stress on cutaneous nociceptive threshold was investigated in female Wistar rats at different stages of the estrous cycle. Baseline tail flick latencies did not change significantly during the cycle. However after brief exposure to vibration stress (4 Hz for 5 min), rats in late diestrus, but not at other cycle stages, developed a hyperalgesia (decrease in tail flick latency). Animals in late diestrus revealed a more than fivefold increase in the density of Fos-like immunoreactive nuclei in the dorsolateral, lateral, and ventrolateral columns in the caudal half of the periaqueductal gray matter (PAG). There was no change in the density of Fos-like immunoreactive nuclei in the PAG in rats in estrus and early diestrus, although rats in proestrus showed a smaller (50%) but significant increase. Rats undergoing withdrawal from a progesterone dosing regimen (5 mg/kg i.p. twice daily for 6 days) designed to mimic the fall in progesterone that occurs naturally during late diestrus, exhibited a stress-induced hyperalgesia that was similar to animals in late diestrus and a significant increase in Fos-positive cells in the PAG. We suggest that falling levels of progesterone during late diestrus may be a predisposing factor for the development of stress-induced hyperalgesia, which is linked to differential activation of descending pain control circuits in the PAG. Similar changes in women, when progesterone levels fall during the late luteal phase of the menstrual cycle, may contribute to the development of premenstrual symptoms that include increased anxiety and hyperalgesia.

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“…This may provide another reason for the shortened hospital stay since patients who received carbohydrate supplementation were less anxious prior to surgery. Previous studies suggest that preoperative anxiety is related to the degree of pain experienced postoperatively (88). Greater postoperative pain can result in decreased ambulation or mobility, increased analgesic requirements which may result in side effects such as nausea and vomiting, and ultimately a longer hospital stay (89).…”

Section: Discussionmentioning

confidence: 99%

Preoperative Carbohydrate Loading in Patients Undergoing Coronary Artery Bypass or Spinal Surgery

Tran¹,

Wolever²,

Errett³

et al. 2014

Survey of Anesthesiology

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Patients undergoing elective surgery typically fast for 8-12 hours before surgery. However, oral preoperative carbohydrate ingestion may increase postoperative insulin sensitivity and reduce complications. To determine the effects of carbohydrate supplementation prior to CABG or spinal surgery, 38 patients were randomized to receive a carbohydrate supplement or to fast for 12 hours preoperatively. Baseline and postoperative measurements of insulin sensitivity were completed using the short insulin tolerance test and homeostasis model assessment (HOMA). Patient discomfort was measured immediately before surgery. Insulin sensitivity was not significantly different between groups. However, the supplemented group experienced a significantly smaller rise in glucose levels following surgery (p=0.03) and had higher postoperative HOMA-β scores (p=0.02). Fasted patients were significantly more thirsty (p=0.01), hungry (p=0.04) and anxious (p=0.01) before surgery and experienced a significantly longer hospital stay (p=0.008). Carbohydrate supplementation improved outcomes, warranting re-evaluation of fasting practices prior to major surgery.ii ACKNOWLEDGEMENTS

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Preoperative anxiety and postoperative pain in women undergoing hysterectomy

Cited by 241 publications

References 33 publications

Comparing cardiovascular load by heart rate variability (HRV) including pNNxx parameters with ratings of perceived medical intervention load (PMIL) in patients undergoing carotid endarterectomy or carotid artery stenting

Comparing cardiovascular load by heart rate variability (HRV) including pNNxx parameters with ratings of perceived medical intervention load (PMIL) in patients undergoing carotid endarterectomy or carotid artery stenting

Differential Activation of the Periaqueductal Gray by Mild Anxiogenic Stress at Different Stages of the Estrous Cycle in Female Rats

Preoperative Carbohydrate Loading in Patients Undergoing Coronary Artery Bypass or Spinal Surgery

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