Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
University of Valladolid, Valladolid, Spain.
Sci Rep. 2022 Oct 1;12(1):16464. doi: 10.1038/s41598-022-20870-9.
Patients undergoing cardiac surgery represent a challenge in terms of pain management due to multiple factors relating to the patients and to the procedure itself. Our aim was to identify the influence of levels of preoperative anxiety on postoperative pain in patients undergoing cardiac surgery and explore associations between preoperative anxiety, postoperative pain, analgesic requirements, and sex. We present a prospective cohort study of 116 patients undergoing cardiac surgery between January and April 2020. Preoperative anxiety was evaluated using the State-Trait Anxiety Inventory and the amount of morphine needed to keep pain intensity below 4 on the verbal numerical rating scale was recorded for 48 h post-surgery. Given the extracorporeal circulation time, type of surgery and body surface, it was observed that every percentile increase in preoperative state anxiety led to an extra 0.068 mg of morphine being administered. For each extra year of age, the amount of morphine needed decreased by 0.26 mg, no difference was observed between men and women in terms of preoperative anxiety or postoperative analgesics requirements. It may be concluded that in cardiac surgery, postoperative analgesic requirements increased with higher levels of preoperative state anxiety and decreased for every extra year of age.
接受心脏手术的患者在疼痛管理方面面临挑战，这涉及到患者和手术本身的多种因素。我们的目的是确定术前焦虑程度对接受心脏手术患者术后疼痛的影响，并探讨术前焦虑、术后疼痛、镇痛需求和性别之间的关系。我们进行了一项前瞻性队列研究，纳入了 2020 年 1 月至 4 月期间接受心脏手术的 116 名患者。使用状态-特质焦虑量表评估术前焦虑，记录术后 48 小时内将疼痛强度维持在数字评分量表 4 分以下所需的吗啡量。考虑到体外循环时间、手术类型和体表面积，观察到术前状态焦虑每增加一个百分位，就需要额外注射 0.068 毫克吗啡。每增加 1 岁，所需的吗啡量就减少 0.26 毫克，男性和女性在术前焦虑或术后镇痛需求方面没有差异。可以得出结论，在心脏手术中，术后镇痛需求随术前状态焦虑程度的增加而增加，随年龄的增加而减少。
