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动静脉内瘘手术期间听音乐可减轻焦虑:一项随机单盲临床试验。

Listening to music during arteriovenous fistula surgery alleviates anxiety: A randomized single-blind clinical trial.

作者信息

Cimen Sanem Guler, Oğuz Ebru, Gundogmus Ayse Gokcen, Cimen Sertac, Sandikci Fatih, Ayli Mehmet Deniz

机构信息

Department of General Surgery, Diskapi Research and Training Hospital, Health Sciences University, Ankara 06110, Turkey.

Division of Nephrology, Department of Internal Medicine, Diskapi Research and Training Hospital, Health Sciences University, Ankara 06110, Turkey.

出版信息

World J Transplant. 2020 Apr 29;10(4):79-89. doi: 10.5500/wjt.v10.i4.79.

Abstract

BACKGROUND

Both end-stage renal disease and being wait-listed for a kidney transplant are anxiety-causing situations. Wait-listed patients usually require arteriovenous fistula surgery for dialysis access. This procedure is performed under local anesthesia. We investigated the effects of music on the anxiety, perceived pain and satisfaction levels of patients who underwent fistula surgery.

AIM

To investigate the effect of music therapy on anxiety levels and perceived pain of patients undergoing fistula surgery.

METHODS

Patients who were on a waiting list for kidney transplants and scheduled for fistula surgery were randomized to control and music groups. The music group patients listened to music throughout the fistula surgery. The State-Trait Anxiety Inventory was performed to assess anxiety, additionally visual analog scale was used to evaluate perceived pain, willingness to repeat the procedure and patient satisfaction. Demographic features, comorbidities, surgical history, basic surgical data (location of fistula creation, duration of surgery, incision length) and intra-operative hemodynamic parameters were recorded by an investigator blinded to the study group. An additional trait anxiety assessment was performed following the surgery.

RESULTS

There was a total of 55 patients included in the study. However, 14 patients did not fulfill the criteria due to requirement of sedation during surgery or uncompleted questionnaires. The remaining 41 patients were included in the analysis. There were 26 males and 15 females. The control and music groups consisted of 20 and 21 patients, respectively. With regard to basic surgical and demographic data, there was no difference between the groups. Overall patient satisfaction was significantly higher and intra-operative heart rate and blood pressure were significantly lower in the music group ( < 0.05). Postoperative state anxiety levels were significantly lower in the music group.

CONCLUSION

Music therapy can be a complimentary treatment for patients undergoing fistula surgery. It can reduce anxiety and perceived pain, improve intraoperative hemodynamic parameters and enhance treatment satisfaction, thus may contribute to better compliance of the patients.

摘要

背景

终末期肾病以及等待肾脏移植均会引发焦虑情绪。等待移植的患者通常需要进行动静脉内瘘手术以建立透析通路。该手术在局部麻醉下进行。我们研究了音乐对接受内瘘手术患者的焦虑、疼痛感知及满意度的影响。

目的

探讨音乐疗法对接受内瘘手术患者焦虑水平及疼痛感知的影响。

方法

将等待肾脏移植且计划行内瘘手术的患者随机分为对照组和音乐组。音乐组患者在内瘘手术全程聆听音乐。采用状态-特质焦虑问卷评估焦虑情况,另外使用视觉模拟量表评估疼痛感知、再次接受该手术的意愿及患者满意度。由对研究分组不知情的研究者记录人口统计学特征、合并症、手术史、基本手术数据(内瘘建立位置、手术时长、切口长度)及术中血流动力学参数。术后进行额外的特质焦虑评估。

结果

本研究共纳入55例患者。然而,14例患者因手术期间需要镇静或问卷未完成而不符合标准。其余41例患者纳入分析。其中男性26例,女性15例。对照组和音乐组分别有20例和21例患者。在基本手术和人口统计学数据方面,两组之间无差异。音乐组患者总体满意度显著更高,术中心率和血压显著更低(P<0.05)。音乐组术后状态焦虑水平显著更低。

结论

音乐疗法可作为接受内瘘手术患者的辅助治疗方法。它可减轻焦虑和疼痛感知,改善术中血流动力学参数,提高治疗满意度,从而可能有助于患者更好地配合治疗。

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