Children's Orthopedic Center, Children's Hospital Los Angeles, Los Angeles, CA.
J Pediatr Orthop. 2020 Oct;40(9):e794-e797. doi: 10.1097/BPO.0000000000001549.
Parental mental status and behavior may influence postoperative recovery and the use of pain medication. The purpose of this study is to identify if parents with high anxiety are associated with prolonged narcotic use in adolescent patients following posterior spinal fusion surgery. Prolonged narcotic use in this study was defined as opioid use at their first postoperative visit.
AIS patients age 11 to 20 years undergoing posterior spinal fusion and a parent were prospectively enrolled. At the preoperative appointment, patients completed the Spence Children's Anxiety Scale and parents completed the State-Trait Anxiety Inventory. High parental anxiety was defined as 1 SD above the normative mean. At the first postoperative visit, patients were asked about medication use.
A total of 58 patients (49 females and 9 males) were enrolled. Overall, 29% (17/58) of parents had a high general anxiety trait on the State-Trait Anxiety Inventory and 71% (41/58) had normal general anxiety. Of the patients whose parents had high general anxiety, 47% (8/17) were still taking narcotics at their first postoperative visit compared with 20% (8/41) of patients with normal anxiety parents (P=0.03).
Patients with high general anxiety parents were more than twice as likely to still be on narcotics at their first postoperative visit. This information can be used to counsel families on the impact of anxiety on narcotic usage.
Level II-prognostic studies-investigating the effect of a patient characteristic on the outcome of the disease.
父母的精神状态和行为可能会影响术后恢复和止痛药的使用。本研究的目的是确定焦虑程度较高的父母是否与青少年后路脊柱融合术后患者的阿片类药物使用时间延长有关。本研究中，阿片类药物使用时间延长定义为术后首次就诊时使用阿片类药物。
前瞻性纳入年龄在 11 至 20 岁之间接受后路脊柱融合术的 AIS 患者及其父母。在术前预约时，患者完成 Spence 儿童焦虑量表，父母完成状态-特质焦虑问卷。高父母焦虑定义为高于正常均值 1 个标准差。在第一次术后就诊时，询问患者用药情况。
共纳入 58 例患者（女性 49 例，男性 9 例）。总体而言，29%（17/58）的父母在状态-特质焦虑问卷中存在较高的一般特质焦虑，71%（41/58）的父母存在正常的一般焦虑。在父母一般焦虑程度较高的患者中，47%（8/17）的患者在第一次术后就诊时仍在服用阿片类药物，而父母一般焦虑正常的患者中只有 20%（8/41）（P=0.03）。
父母一般焦虑程度较高的患者在第一次术后就诊时仍服用阿片类药物的可能性是父母一般焦虑正常的患者的两倍多。此信息可用于向患者家属提供焦虑对阿片类药物使用影响的相关咨询。
Ⅱ级-预后研究-调查患者特征对疾病结局的影响。
