Yan Fen, Yuan Li-Hua, He Xiao, Yu Kai-Feng
Department of Anesthesiology, Wuhan Pulmonary Hospital, Wuhan Institute for Tuberculosis Control, Wuhan 430000, Hubei Province, China.
World J Psychiatry. 2024 Jun 19;14(6):930-937. doi: 10.5498/wjp.v14.i6.930.
Preoperative anxiety is a common emotional problem during the perioperative period and may adversely affect postoperative recovery. Emergence agitation (EA) is a common complication of general anesthesia that may increase patient discomfort and hospital stay and may be associated with the development of postoperative complications. Pre-anesthetic anxiety may be associated with the development of EA, but studies in this area are lacking.
To determine the relationship between pre-anesthetic anxiety and EA after radical surgery in patients with non-small cell lung cancer (NSCLC).
Eighty patients with NSCLC undergoing surgical treatment between June 2020 and June 2023 were conveniently sampled. We used the Hospital Anxiety and Depression Scale's (HADS) anxiety subscale (HADS-A) to determine patients' anxiety at four time points (T1-T4): Patients' preoperative visit, waiting period in the surgical waiting room, after entering the operating room, and before anesthesia induction, respectively. The Riker Sedation-Agitation Scale (RSAS) examined EA after surgery. Scatter plots of HADS-A and RSAS scores assessed the correlation between patients' pre-anesthesia anxiety status and EA. We performed a partial correlation analysis of HADS-A scores with RSAS scores.
NSCLC patients' HADS-A scores gradually increased at the four time points: 7.33 ± 2.03 at T1, 7.99 ± 2.22 at T2, 8.05 ± 2.81 at T3, and 8.36 ± 4.17 at T4. The patients' postoperative RSAS score was 4.49 ± 1.18, and 27 patients scored ≥ 5, indicating that 33.75% patients had EA. HADS-A scores at T3 and T4 were significantly higher in patients with EA (9.67 ± 3.02 7.23 ± 2.31, 12.56 ± 4.10 6.23 ± 2.05, < 0.001). Scatter plots showed the highest correlation between HADS-A and RSAS scores at T3 and T4. Partial correlation analysis showed a strong positive correlation between HADS-A and RSAS scores at T3 and T4 ( = 0.296, 0.314, < 0.01).
Agitation during anesthesia recovery in patients undergoing radical resection for NSCLC correlated with anxiety at the time of entering the operating room and before anesthesia induction.
术前焦虑是围手术期常见的情绪问题，可能对术后恢复产生不利影响。苏醒期躁动（EA）是全身麻醉的常见并发症，可能增加患者不适和住院时间，并可能与术后并发症的发生有关。麻醉前焦虑可能与EA的发生有关，但该领域的研究较少。
确定非小细胞肺癌（NSCLC）患者根治性手术后麻醉前焦虑与EA之间的关系。
方便抽样选取2020年6月至2023年6月期间接受手术治疗的80例NSCLC患者。我们使用医院焦虑抑郁量表（HADS）的焦虑分量表（HADS-A）在四个时间点（T1-T4）确定患者的焦虑程度：分别为患者术前就诊时、在手术等候室等待期间、进入手术室后以及麻醉诱导前。使用Richmond躁动镇静量表（RSAS）评估术后的EA情况。HADS-A和RSAS评分的散点图评估了患者麻醉前焦虑状态与EA之间的相关性。我们对HADS-A评分与RSAS评分进行了偏相关分析。
NSCLC患者的HADS-A评分在四个时间点逐渐升高：T1时为7.33±2.03，T2时为7.99±2.22，T3时为8.05±2.81，T4时为8.36±4.17。患者术后RSAS评分为4.49±1.18，27例患者评分≥5，表明33.75%的患者发生了EA。发生EA的患者在T3和T4时的HADS-A评分显著更高（9.67±3.02对7.23±2.31，12.56±4.10对6.23±2.05，P<0.001）。散点图显示T3和T4时HADS-A与RSAS评分之间的相关性最高。偏相关分析显示T3和T4时HADS-A与RSAS评分之间存在强正相关（r=0.296，0.314，P<0.01）。
NSCLC根治性切除患者麻醉恢复期间的躁动与进入手术室时和麻醉诱导前的焦虑相关。
