Bala Aleksandra, Olejnik Agnieszka, Dziedzic Tomasz, Piwowarska Jolanta, Podgórska Anna, Marchel Andrzej
Faculty of Psychology, University of Warsaw, Warsaw, Poland.
Department of Neurosurgery, Medical University of Warsaw, Warsaw, Poland.
J Neuropsychol. 2024 Mar;18(1):30-46. doi: 10.1111/jnp.12311. Epub 2023 Apr 10.
There is growing interest in awake craniotomies, but some clinicians are concerned that such procedures are poorly tolerated by patients. Therefore, we conducted a study to assess this phenomenon. In this prospective qualitative study, 68 patients who qualified for awake craniotomy were asked to complete the Hospital Anxiety and Depression Scale (HADS)-two days before the surgery and visual analogue scales (VAS) for pain and stress, two days before the surgery and again about two days after. In addition, after their surgery, they took part in a structured interview about what helped them prepare for and cope with the surgery. Most patients tolerated the awake surgery well, scoring low on stress and pain scales. They reported a lower level of stress during the surgery (when questioned afterwards) than before it. Intensity of stress before the surgery correlated negatively with age, positively with HADS anxiety score and positively with stress subsequently experienced during surgery. The level of stress during surgery was associated with stress experienced before the surgery, pain and HADS anxiety and depression scores. Severity of pain during the surgery was positively correlated with stress during surgery and HADS depression and anxiety scores before the surgery. There was no correlation between stress, pain, anxiety and depression and the location of the lesion. Patients have a high tolerance for awake craniotomy. Various factors have an impact on how well patients cope with the operation. Extensive preoperative preparation should be considered a key part of the procedure.
人们对清醒开颅手术的兴趣日益浓厚，但一些临床医生担心患者对这类手术的耐受性较差。因此，我们开展了一项研究来评估这一现象。在这项前瞻性定性研究中，68名符合清醒开颅手术条件的患者被要求在手术前两天完成医院焦虑抑郁量表（HADS），以及疼痛和压力视觉模拟量表（VAS）——手术前两天一次，术后约两天再一次。此外，手术后，他们参加了一次结构化访谈，内容是关于什么帮助他们为手术做准备以及应对手术。大多数患者对清醒手术耐受性良好，在压力和疼痛量表上得分较低。他们报告称，手术期间（事后询问时）的压力水平低于手术前。手术前的压力强度与年龄呈负相关，与HADS焦虑评分呈正相关，与手术期间随后经历的压力呈正相关。手术期间的压力水平与手术前经历的压力、疼痛以及HADS焦虑和抑郁评分有关。手术期间的疼痛严重程度与手术期间的压力以及手术前的HADS抑郁和焦虑评分呈正相关。压力、疼痛、焦虑和抑郁与病变位置之间没有相关性。患者对清醒开颅手术具有较高的耐受性。各种因素会影响患者应对手术的情况。广泛的术前准备应被视为该手术的关键部分。
