Usefulness of pre-anesthetic consultation to reduce the degree of anxiety in patients scheduled for surgical intervention. / Utilidad de la consulta preanestésica para disminuir el grado de ansiedad en pacientes programados para intervención quirúrgica.

BACKGROUND AND OBJECTIVES: Preoperative anxiety can alter perioperative evolution, increasing the need for sedatives and analgesics. Information received during the pre-anesthesia consultation could reduce the level of anxiety. The objective of this study was to determine whether preoperative anxiety levels decrease after the pre-anesthesia consultation. MATERIAL AND METHODS: Observational, unicentric, prospective study. Sociodemographic and clinical data were recorded. Heart rate, blood pressure and anxiety levels were measured before and after the pre-anesthesia consultation using the abbreviated State-Trait Anxiety Inventory. Results were analyzed using Wilcoxon test and univariate logistic regression. P=.05 was considered significant. RESULTS: Ninety patients were included, with a median age of 62 years; 58% were females, 79% had completed primary-secondary studies, 72% were selected for ambulatory surgery and 72% preferred regional anesthesia. The prevalence of anxiety was 35.6% (State-Trait Anxiety Inventory score 5; IQR 3-9); after the anesthesia consultation the score was reduced to 4 (IQR 2-6), P=.005. There was no significative decrease in hemodynamic values, and no significant relationship between anxiety and sociodemographic or clinical variables. CONCLUSIONS: The pre-anesthesia consultation reduces anxiety levels in surgical patients. This emphasizes the importance of the pre-anesthesia consultation in identifying and managing anxiety.

The Effects of the Preoperative Education about Analgesics and Patient-Controlled Analgesia (PCA) on the Consumption of Analgesics after Operation / 대한마취과학회지

BACKGROUND: The purpose of this study is to evaluate the patients' general perception about the analgesics and the effects of the preoperative education about analgesics and patient-controlled analgesia (PCA). METHODS: One hundred patients scheduled for elective gastrectomy were randomly allocated into two groups. In control group (n = 50), patients were given conventional preanesthetic visit with questionnaire survey on PCA one day before operation. In study group (n = 50), patients were sufficiently explained about postoperative analgesia and PCA by anesthesiologist and given precise explanation sheet about PCA. Total amounts of drug used in PCA as well as rescue analgesics, the pain scores, and side effects were compared. RESULTS: 62.2% of patients had much information from various sources that analgesics effects positively in the recovery phase, but actually 73.7% of patients considered that analgesics do not seem to have any influence on the recovery after operation. There was no difference between the amounts of total PCA used, rescue analgesics, and the pain scores. However, the educated patients complained less dizziness at postoperative days (POD) one. Also, the number of patients excluded from study due to the PCA discontinuation secondary to related side effects was less in educated patients (P = 0.025). CONCLUSIONS: Preoperative education about analgesics and PCA failed to demonstrate significant decrease in the amount of analgesics and of pain scores. However, it lowered the incidence of PCA discontinuation due to side effects.

Parental Anxiety about the Risk of Anesthesia of Pediatric Patients / 대한마취과학회지

BACKGROUND: Psychological preparation to reduce preoperative anxiety is one of the main purposes of preoperative visits. However, there are only a few reports about the parental anxiety of pediatric patients. This study was performed to get some information to reduce parental anxiety of pediatric patients through an interview during the preanesthetic visit. METHODS: We collected data from the parents of the 122 preoperative children younger than 18 years old and scheduled for elective surgery. The questionnaire consisted of the demographic data, the severity of anxiety, the reason of anxiety, and the parental understanding level about anesthesia before and after hospitalization. RESULTS: The most common cause of anxiety was about fear "not to recover from anesthesia" (33.1%), which appears to be usually due to lack of medical knowledge about anesthesia (65.1%). After hospitalization, parental understanding level about anesthesia was increased. CONCLUSIONS: Anesthesiologists should explain anticipated events and the proposed anesthetic management, which would increase the understanding of parents about anesthesia. Therefore, anxiety and apprehension about anesthesia can be reduced.