患者对术前抗焦虑药物的需求——一项择期手术成人患者的观察性研究。

Patients' desires for anxiolytic premedication - an observational study in adults undergoing elective surgery.

机构信息

Department of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Gutenbergstrasse 18, 35032, Marburg, Germany.

Department of Psychology, Clinical Psychology and Psychotherapy, Medical School Berlin, Calandrellistrasse 1-9, 12247, Berlin, Germany.

出版信息

BMC Psychiatry. 2022 Mar 17;22(1):193. doi: 10.1186/s12888-022-03845-y.

DOI:10.1186/s12888-022-03845-y

PMID:35300643

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8932104/

Abstract

BACKGROUND

Most patients experiencing preoperative anxiety would welcome support in coping with their anxiety. Anxiolytic medication is a common way to address preoperative anxiety. However, the proportion of patients who welcome anxiolytic medication preoperatively and the preferred time of taking it have not been studied thoroughly.

METHODS

Adult patients (n = 1000) scheduled to undergo elective surgery under general anesthesia were eligible to participate in this single-center observational study. Primary outcomes were the ratio of patients desiring anxiolytic medication (no/yes/on request) and the preferred time of taking it (evening before surgery/morning of day of surgery/on call to the operating room). Secondary outcomes included associations between different measures of anxiety (i.e., anxiety level according to the Amsterdam Preoperative Anxiety and Information Scale (APAIS) and anxiety status (no/yes)) and desire for anxiolytic medication (no/yes/on request). Primary outcomes were analyzed descriptively, and secondary outcomes were analyzed using multinomial logistic regressions.

RESULTS

Three hundred fifty-six (35.6%) out of 1000 patients desired anxiolytic medication and 239 (23.9%) patients would welcome anxiolytic medication on request. In patients reporting anxiety (no/yes; n = 493), 228 (46.2%) stated a clear desire for anxiolytic medication (yes) and 142 (28.8%) considered anxiolytic medication (on request). Patients' preferences concerning the timing of premedication vary widely. In patients reporting a clear desire for anxiolytic medication (n = 356), the "morning of the day of surgery" was most frequently (n = 111, 31.2%) stated as the preferred time to get anxiolytic medication, followed by "on call to the operating room" (n = 51, 14.3%). All anxiety measures were significantly associated with desire for anxiolytic medication (p < 0.05).

CONCLUSIONS

Given the importance of preoperative anxiety to patients, patients' desire for anxiolytic medication should be considered when discussing the pros and cons of premedication. Individualized instead of standardized prescription and timing of premedication is recommended.

TRIAL REGISTRATION

German Clinical Trials Register ( DRKS 00013319 , approved 23/11/2017).

摘要

背景

大多数经历术前焦虑的患者都希望在应对焦虑方面得到支持。使用抗焦虑药物是解决术前焦虑的常用方法。然而，术前欢迎使用抗焦虑药物的患者比例以及服用药物的首选时间尚未得到充分研究。

方法

符合全身麻醉下择期手术条件的成年患者（n = 1000）有资格参加这项单中心观察性研究。主要结局指标是患者对使用抗焦虑药物的需求比例（无/是/按需）和服用药物的首选时间（手术前一天晚上/手术当天早上/手术室召唤时）。次要结局指标包括不同焦虑测量指标（即根据阿姆斯特丹术前焦虑和信息量表（APAIS）的焦虑程度和焦虑状态（无/是））与使用抗焦虑药物的意愿（无/是/按需）之间的关联。主要结局指标进行描述性分析，次要结局指标使用多项逻辑回归分析。

结果

在 1000 名患者中，356 名（35.6%）患者需要抗焦虑药物，239 名（23.9%）患者会按需接受抗焦虑药物。在报告焦虑的患者中（无/是；n = 493），228 名（46.2%）明确表示需要抗焦虑药物（是），142 名（28.8%）考虑使用抗焦虑药物（按需）。患者对药物预治疗时间的选择差异很大。在明确表示需要抗焦虑药物的患者中（n = 356），“手术当天早上”（n = 111，31.2%）是最常选择的服药时间，其次是“手术室召唤时”（n = 51，14.3%）。所有焦虑测量指标均与使用抗焦虑药物的意愿显著相关（p < 0.05）。