Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Department of Anesthesiology, Yonsei University College of Medicine, Gangnam Severance Hospital, Yonsei University Health System, Seoul, Republic of Korea.
J Crit Care. 2018 Oct;47:65-69. doi: 10.1016/j.jcrc.2018.05.014. Epub 2018 Jun 2.
Pain and anxiety are understudied despite their importance to the general medical condition. The aim of the present study was to examine the effects of pain and anxiety and their relationship to the doses of opioids and anxiolytics administered in intensive care unit (ICU) patients.
The subjects included 1349 conscious, critically ill patients admitted to an ICU. Psychiatrists evaluated the patients daily for pain and anxiety. Data regarding the doses of opioids and benzodiazepines administered were gathered. Linear mixed model was used for analysis.
The pain and anxiety experienced by patients in the ICU were significantly correlated. Pain had significant main effects on the dose of opioids administered. No significant effects of anxiety on the daily dose of anxiolytics or opioids given were detected.
Due to their closely linked relationship, pain and anxiety, can affect one another, and one can influence the other to appear more severe. In addition, anxiety can be underestimated in ICU patients. The present study suggests the need for precise evaluation and a comprehensive approach to the management of pain and anxiety. In addition, this study implies that management of anxiety may affect pain reduction, given the close correlation between the two.
尽管疼痛和焦虑对于一般的医疗状况很重要,但它们的研究仍不够充分。本研究的目的是探讨疼痛和焦虑及其与重症监护病房(ICU)患者使用的阿片类药物和抗焦虑药物剂量的关系。
本研究纳入了 1349 名入住 ICU 的有意识、重病患者。精神科医生每天评估患者的疼痛和焦虑程度。收集了阿片类药物和苯二氮䓬类药物的剂量数据。采用线性混合模型进行分析。
ICU 患者的疼痛和焦虑明显相关。疼痛对阿片类药物的剂量有显著的主要影响。焦虑对每日抗焦虑药物或阿片类药物剂量没有显著影响。
由于疼痛和焦虑密切相关,它们可以相互影响,一种情况可能会使另一种情况显得更严重。此外,ICU 患者的焦虑可能被低估了。本研究表明,需要对疼痛和焦虑进行精确评估和综合管理。此外,鉴于两者之间的密切相关性,焦虑的管理可能会影响疼痛的缓解。