[Anxiety assessment in parturients requesting epidural analgesia for pain relief]. / Ocena leku u rodzacych zdecydowanych na analgezje zewnatrzoponowa.

OBJECTIVES: Neuraxial methods provide the most effective labor pain relief. This study aimed at assessing anxiety level in parturients requesting epidural analgesia (EA). MATERIAL AND METHODS: Forty five women in spontaneous, active labor were enrolled, both primiparas (n=36) and multiparas (n=9). Anxiety was assessed by means of Spielberger State and Trait Anxiety Inventory (STAI) before administration of EA, and pain was measured by visual-analog scale (VAS) before and after analgesia. RESULTS: In all the studied parturients state anxiety was strikingly higher than the trait (53.9 +/- 11.8 vs. 39.3 +/- 8.4; P < 0.0001); the difference appeared insignificant in multiparas only. State anxiety was comparable independently of parity, labor outcome and systemic opioid administration. No association between anxiety level and labor pain intensity preceding analgesia, the duration of labor stages and demographic parameters could be found. However, a negative correlation between state anxiety and pain intensity reported after EA administration was noted (R = -0.315, p = 0.040), and, in cases of physiological labor, a negative association between state anxiety and the neonate Apgar score at the 1st minute after birth could be observed (R = -0.337, p = 0.047, Spearman rank test). CONCLUSIONS: In parturients requesting EA, state anxiety level is increased and not connected with the trait. Furthermore, in these women, anxiety appears not to be associated with labor pain but may influence the analgesic effect of the blockade. Anxiety does not determine labor duration and outcome; however, it may be connected with the well-being of the neonate immediately after birth.

[Significance of smoking and cigarette abstinence regarding anxiety in gynecologic patients in a perioperative period]. / Znaczenie palenia papierosów i jego zaprzestania w aspekcie leku u pacjentek ginekologicznych w okresie okolooperacyjnym.

Smoking cigarettes adds to risk of anesthesia and surgery, and also may influence anxiety. However, cigarette abstinence may increase preoperative stress. The study aimed at exploring the relationship between smoking and anxiety in gynaecologic patients in the perioperative period, and also finding out whether the abstinence and history of unsuccessful cessation attempts are connected with an anxiety pattern at that time. A relationship between anxiety and postoperative pain should be also examined. In 24 smokers and 24 non-smokers subjected to hysterectomy the anxiety level was examined by means of both Spielberger's state and trait inventory (STAI) and visual-analog scale (VAS) before and following surgery; maximal pain on the first postoperative day was also assessed by VAS scale. Smokers additionally completed an inventory of smoking behavior. Pre- and postoperatively the anxiety level was comparable in both groups. Before surgery but not after it, state anxiety overtopped the trait in both smokers and non-smokers. Postoperatively state anxiety was connected with the trait and morphine consumption. Cigarette abstinence before surgery did not influence anxiety; however, state anxiety correlated with the length of abstinence. In smokers with the history of smoking cessation attempts, preoperative state anxiety was higher. Between smokers and non-smokers no differences in postoperative pain and no significant relationship with the anxiety could be found, Conclusions: 1) Perioperative anxiety is comparable in both smoking and non-smoking gynaecologic patients. 2) Cigarette abstinence before surgery is not connected with any significant anxiety differences. Smokers with the history of unsuccessful cessation attempts preoperatively present with higher state anxiety.

[Perioperative anxiety in female smokers subjected to gynaecological surgery--a preliminary report]. / Poziom leku w okresie okolooperacyjnym u pacjentek ginekologicznych a nalóg palenia tytoniu--doniesienie wstepne.

UNLABELLED: Anxiety constitutes one of the most important psychological factors influencing body reaction to surgical injury; in gynecological patients anxiety ratings appear especially high. Cigarette smoking belongs to essential risk factors in the perioperative period and may result in increased levels of anxiety. A pilot study has been carried out with the aim of evaluating the impact of smoking habit on the perioperative anxiety level and postoperative pain in women undergoing gynecological surgical procedures. In 9 smokers and 10 non-smokers, anxiety was assessed by means of the State Anxiety Score of the Spielberger State-Trait Anxiety Inventory (STAI) and the visual analog scale (VAS), preoperatively and on the second day after surgery. Additionally, intraoperative and postoperative opioid analgesic uses were analyzed and on the second day after surgery patients rated their recall of postoperative pain with the use of the VAS. Postoperative State anxiety was lower than that reported preoperatively only in non-smokers (median: 53.0-40.0, p=0.02, Wilcoxon p=0.02). Smoking did not significantly influence intra- and postoperative opioid analgesic requirements and postoperative pain. CONCLUSIONS: This study suggests that in female smokers subjected to gynaecological surgery cigarette smoking may contribute to altered anxiety kinetics in the perioperative period.