Drahota A, Galloway E, Stores R, Ward D, Severs M, Dean T
School of Health Sciences & Social Work, University of Portsmouth, James Watson West, 2 King Richard 1st Road, Portsmouth, Hampshire PO12FR, UK.
Foot (Edinb). 2008 Dec;18(4):211-9. doi: 10.1016/j.foot.2008.06.001. Epub 2008 Jul 9.
Minor surgery for ingrown toenails can provoke anxiety and the anaesthetic injection can be acutely painful. Distraction techniques may reduce the associated pain and anxiety.
To investigate an audiovisual distraction (Bedscapes) on pain and anxiety during minor surgery for the correction of ingrown toenail.
In a randomised controlled trial, patients (N=152) with ingrown toenails requiring surgical correction under local anaesthesia were allocated to receive Bedscapes+standard care or standard care alone. Pain levels due to local anaesthetic injection were assessed post-procedure, and anxiety levels were assessed pre- and post-procedure in both groups. Follow-up focus groups were conducted with 14 patients allocated to the Bedscapes group, and one-to-one interviews were held with four podiatrists.
Participants with high pre-procedure anxiety scores experienced greater pain on injection, and older patients reported lower pain than younger patients, regardless of group allocation. Bedscapes did not reduce pain or anxiety, and was apparently no more effective than interpersonal interaction between podiatry staff and the patient.
Pain of injected anaesthesia correlates closely with pre-operative anxiety. Formal audiovisual distraction has no added benefit over interpersonal interaction in the alleviation of pain and anxiety in patients undergoing nail surgery.
嵌甲小手术可能引发焦虑，且麻醉注射会带来剧痛。分心技巧或许能减轻相关疼痛和焦虑。
探讨在嵌甲矫正小手术中，视听分心法（Bedscapes）对疼痛和焦虑的影响。
在一项随机对照试验中，将152例需要在局部麻醉下进行手术矫正嵌甲的患者，随机分为两组，一组接受Bedscapes加标准护理，另一组仅接受标准护理。术后评估局部麻醉注射引起的疼痛程度，两组均在术前和术后评估焦虑程度。对分配到Bedscapes组的14例患者进行随访焦点小组讨论，并与4名足病医生进行一对一访谈。
术前焦虑评分高的参与者注射时疼痛更剧烈，且无论分组如何，老年患者报告的疼痛低于年轻患者。Bedscapes并未减轻疼痛或焦虑，且显然不比足病医护人员与患者之间的人际互动更有效。
注射麻醉的疼痛与术前焦虑密切相关。在减轻指甲手术患者的疼痛和焦虑方面，正规的视听分心法相比人际互动并无额外益处。
