Rajput Sachin K, Tiwari Tanmay, Chaudhary Ajay K
Department of Anesthesia and Critical Care, King George's Medical University, Lucknow, Uttar Pradesh, India.
J Family Med Prim Care. 2021 Jan;10(1):237-242. doi: 10.4103/jfmpc.jfmpc_1544_20. Epub 2021 Jan 30.
Pre-anesthesia checkup (PAC) gives unique opportunity for providing necessary information, patient education and allaying anxiety. Our objective was to measure the effect of preoperative multimedia video information (self made short video of 12 minutes) on patient's anxiety and hemodynamic parameters during surgery under spinal anesthesia.
This prospective randomized study was conducted in 80 patients of either sex with ASA physical status I and II posted for lower limb surgery under spinal anesthesia. Patents were randomized to control or test group. At the end of preoperative visit, patients in test group watched the film and patient in control group did not watch any video. Verbal briefing by the attending anesthesiologist on the day of surgery was given to all patients of both the groups. Anxiety using Amsterdam Preoperative Anxiety and Information Scale (APAIS) and hemodynamic parameters (SBP, DBP and HR) at various time intervals (A1: Baseline, A2: post intervention, A3: just before surgery, A4: after surgery) were measured.
Baseline anxiety (A1) scores were severe in both the groups and showed no statistical significance ( = 0.436). Patients in test group (video) showed better/lower anxiety levels than the control group (non video) at A2 ( = 0.020) and A3 ( = 0.005) respectively, similarly hemodynamic parameters were better controlled and showed lesser deviation from baseline values in test group as compared to control group and showed statistical significant difference ( < 0.001) just before surgery.
Combination of multimedia based video information at the time of PAC and short verbal briefing on the day of surgery by the attending anesthesiologist provides effective management of perioperative anxiety. It can be cost effective way of enhancing patient care and providing adequate information to people with reading and comprehension difficulties.
麻醉前检查（PAC）为提供必要信息、患者教育及缓解焦虑提供了独特机会。我们的目的是评估术前多媒体视频信息（自制的12分钟短视频）对脊髓麻醉下手术患者焦虑及血流动力学参数的影响。
本前瞻性随机研究纳入80例拟行脊髓麻醉下下肢手术的ASA身体状况为I级和II级的患者，性别不限。患者被随机分为对照组和试验组。术前访视结束时，试验组患者观看影片，对照组患者不观看任何视频。两组所有患者在手术当天均由主治麻醉医生进行口头讲解。使用阿姆斯特丹术前焦虑与信息量表（APAIS）测量焦虑程度，并在不同时间间隔（A1：基线，A2：干预后，A3：手术前，A4：手术后）测量血流动力学参数（收缩压、舒张压和心率）。
两组的基线焦虑（A1）评分均为重度，无统计学意义（=0.436）。试验组（视频组）患者在A2（=0.020）和A3（=0.005）时的焦虑水平分别低于对照组（非视频组），同样，试验组的血流动力学参数得到更好控制，与对照组相比，术前偏离基线值的程度更小，差异有统计学意义（<0.001）。
PAC时基于多媒体的视频信息与手术当天主治麻醉医生的简短口头讲解相结合，可有效管理围手术期焦虑。这可能是一种提高患者护理质量并为有阅读和理解困难的人群提供充分信息的经济有效的方法。
