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[全身麻醉与局部麻醉用于眼内手术时的围手术期焦虑及术后疼痛抑制]

[Perioperative anxiety and postoperative pain suppression in intraocular operations using general anesthesia and local anesthesia].

作者信息

Schäffer J, Mehrmann M, Heymann-Schramm S, Werry H, Piepenbrock S

机构信息

Abteilung Anaesthesiologie II, Medizinischen Hochschule Hannover.

出版信息

Anaesthesist. 1988 Jan;37(1):19-23.

PMID:3354829
Abstract

UNLABELLED

Intraocular surgery is performed under local or general anesthesia. The indications for these procedures are often dependent on local circumstances. On the one hand, the optimal conditions for operations under general anesthesia, on the other, the negligible stress of local anesthesia, especially for the elderly, are emphasized. To clarify this question, perioperative anxiety behavior and postoperative pain were investigated in geriatric patients undergoing ophthalmic surgery.

METHODS

Spielberger's state trait anxiety inventory (STAI) was performed in 31 patients operated on in general (age 71.0 +/- 6.6 SEM) and 31 operated on in local anesthesia (age 71.6 +/- 6.0 SEM) the day before and 4 h after operation. 10 patients in each group were also tested immediately before surgery in the operating room. Postoperative pain was estimated by the patient and postoperative sedation by the investigator using a 4-point scale for each over 8 h.

RESULTS

The state (STAI 1) and trait (STAI 2) anxiety scores did not change in these geriatric patients. There were no significant differences between the groups. Postoperative pain was significantly (p less than 0.05) higher after 15 and 60 min after general anesthesia. There was no difference in the frequency of analgetic therapy in both groups, but most opioids were given in the first 90 min after general anesthesia. The patients were more frequently sedated (p less than 0.05) in the first 90 min after general anesthesia then after local anesthesia.

DISCUSSION

The scores of state and trait anxiety behavior are comparable to a normal geriatric population, even if normal data cannot always be applied to clinical situations.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

未标注

眼内手术在局部或全身麻醉下进行。这些手术的适应症通常取决于当地情况。一方面强调全身麻醉下手术的最佳条件,另一方面强调局部麻醉可忽略不计的应激反应,尤其是对老年人而言。为阐明这个问题,对接受眼科手术的老年患者的围手术期焦虑行为和术后疼痛进行了研究。

方法

对31例接受全身麻醉手术的患者(年龄71.0±6.6标准误)和31例接受局部麻醉手术的患者(年龄71.6±6.0标准误)在手术前一天及术后4小时进行斯皮尔伯格状态特质焦虑量表(STAI)测试。每组10例患者还在手术室手术前即刻进行测试。患者评估术后疼痛,研究者使用4分制量表在8小时以上时间内评估术后镇静情况。

结果

这些老年患者的状态(STAI 1)和特质(STAI 2)焦虑评分没有变化。两组之间没有显著差异。全身麻醉后15分钟和60分钟时术后疼痛显著更高(p<0.05)。两组镇痛治疗的频率没有差异,但大多数阿片类药物在全身麻醉后的前90分钟内给予。全身麻醉后前90分钟内患者比局部麻醉后更频繁地出现镇静(p<0.05)。

讨论

状态和特质焦虑行为评分与正常老年人群相当,即使正常数据不能总是应用于临床情况。(摘要截断于250字)

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