ABSTRACT
BACKGROUND: We aimed to evaluate the effects of preoperative listening to patient-preferred music and classical music on postoperative anxiety and recovery. METHODS: A prospective, randomized controlled, single-blind study included 255 patients who were scheduled for elective inguinal hernia operation under general anesthesia. Spielberger state State-Trait Anxiety Inventory form 1,2 (STAI-I, STAI-II), Quality of Recovery Score-40 (QoR-40) were applied in the preoperatively. In the preoperative period, the preferential music group (group P) patients listened to their favorite music, while patients in the classical music group (group C) listened to classical music, music was not played in the control group (group N). STAI-I, QoR-40 questionnaire, pain status, and patient satisfaction in the postoperative period were recorded by a blinded investigator. RESULTS: A total of 217 patients participated in the study analysis. Postoperative STAI-1 score was lower in group P than in group N (p = 0.025) and was similar among other groups. The postoperative QoR-40 score was significantly higher in group P than in group N (p = 0.003), and it was similar between the other groups. While SBP, DBP and HR premusic and post-music changes were significant, there was no difference in other groups. There was no difference between the groups in the NRS score. The patient satisfaction score was significantly higher in group P. CONCLUSIONS: Preoperative patient-preferred music application reduces postoperative anxiety and improves recovery quality compared to classical music. In addition, regulation of hemodynamic data and patient satisfaction increase in a preferential music application, but pain scores do not change. TRIAL REGISTRATION: NCT04277559| https://www. CLINICALTRIALS: gov/.
ABSTRACT
BACKGROUND: Lower-extremity amputation for a diabetic foot is mainly performed under general or central neuraxial anesthesia. Ultrasound-guided peripheral nerve block (PNB) can be a good alternative, especially for patients who require continuous anticoagulation treatment and patients with additional comorbidities. We evaluated bleeding due to PNB application in patients with diabetic foot receiving antiplatelet or anticoagulant therapy. Perioperative morbidity and mortality and the need for intensive care hospitalization were analyzed. METHODS: This study included 105 patients with diabetic foot or debridement who underwent distal foot amputation or debridement between February and October 2020. Popliteal nerve block (17 mL of 5% bupivacaine and 3 mL of saline) and saphenous nerve block (5 mL of 2% lidocaine) were applied to the patients. Postoperative pain scores (at 4, 8, 12, and 24 hours) and complications due to PNB were evaluated. Intensive care admission and 1-month mortality were recorded. RESULTS: The most common diseases accompanying diabetes were hypertension and peripheral artery disease. No complications due to PNB were observed. Mean ± SD postoperative first analgesic need was determined to be 14.1 ± 4.1 hours. Except for one patient, this group was followed up without the need for postoperative intensive care. In 16 patients, bleeding occurred as leakage from the surgical area, and it was stopped with repeated pressure dressing. Mean ± SD patient satisfaction score was 8.36 ± 1.59. Perioperative mortality was not observed. CONCLUSIONS: Ultrasound-guided PNB can be an effective and safe anesthetic technique for diabetic patients undergoing distal foot amputation, especially those receiving antiplatelet or anticoagulant therapy and considered high risk.