Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China; School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China.
Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China.
J Psychosom Res. 2021 Aug;147:110528. doi: 10.1016/j.jpsychores.2021.110528. Epub 2021 May 19.
To describe patient characteristics associated with preoperative anxiety and subsequently assess the relationship between preoperative anxiety and postoperative anxiety, pain, sleep quality, nausea and vomiting.
The study collected data from patients undergoing elective operation from 12 hospitals in China. The State-Trait Anxiety Inventory (STAI) and the Athens Insomnia Scale (AIS) were used to assess anxiety and sleep quality before surgery. Evaluations of anxiety, pain, sleep quality, nausea and vomiting were quantified using the Visual Analogue Scale on postoperative days 1 and 2.
Data from 997 patients were analyzed. Preoperatively, 258 (25.9%) patients had high anxiety (STAI-State>44). Multivariate analyses showed a significant relationship between high anxiety and female gender (OR: 1.66, 95% CI: 1.08-2.57, p = 0.02), highly invasive surgery (OR: 2.29, 95% CI: 1.29-4.06, p = 0.005), higher trait anxiety (OR: 1.24, 95% CI: 1.20-1.28, p < 0.001) and insomnia (AIS ≥ 6, OR: 1.79, 95% CI: 1.17-2.76, p = 0.008). Preoperative anxiety demonstrated a negative correlation with postoperative anxiety following highly invasive surgery; this became a positive relationship following less invasive surgery. Preoperative anxiety was also positively related to postoperative pain and poor sleep quality. The correlation between preoperative anxiety and postoperative nausea and vomiting was not statistically significant.
Female gender, highly invasive surgery, higher trait anxiety and insomnia are independent risk factors for high preoperative anxiety. Surgical invasiveness influences association between pre- and postoperative anxiety. Higher preoperative anxiety is related to poorer sleep quality and more severe pain postoperatively.
描述与术前焦虑相关的患者特征，并评估术前焦虑与术后焦虑、疼痛、睡眠质量、恶心和呕吐之间的关系。
该研究从中国 12 家医院接受择期手术的患者中收集数据。使用状态特质焦虑量表（STAI）和雅典失眠量表（AIS）评估手术前的焦虑和睡眠质量。术后第 1 天和第 2 天使用视觉模拟量表评估焦虑、疼痛、睡眠质量、恶心和呕吐的情况。
对 997 例患者的数据进行了分析。术前，258 例（25.9%）患者存在高度焦虑（STAI-状态>44）。多变量分析显示，高度焦虑与女性（OR：1.66，95%CI：1.08-2.57，p=0.02）、高侵袭性手术（OR：2.29，95%CI：1.29-4.06，p=0.005）、高特质焦虑（OR：1.24，95%CI：1.20-1.28，p<0.001）和失眠（AIS≥6，OR：1.79，95%CI：1.17-2.76，p=0.008）显著相关。对于高侵袭性手术，术前焦虑与术后焦虑呈负相关；对于低侵袭性手术，两者呈正相关。术前焦虑与术后疼痛和睡眠质量差呈正相关。术前焦虑与术后恶心呕吐无显著相关性。
女性、高侵袭性手术、高特质焦虑和失眠是术前高度焦虑的独立危险因素。手术侵袭性影响术前和术后焦虑之间的关系。较高的术前焦虑与术后睡眠质量较差和疼痛更严重相关。
