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作者信息

Haddad Faten, Rais Sirine, Arfaoui Hajer, Kammoun Emna, Naimi Skander, Mebazaa M'hamed Sami

机构信息

Department of Anesthesia and Intensive Care, Mongi Slim Hospital, La Marsa, Tunis. Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

出版信息

Tunis Med. 2024 Oct 5;102(10):664-670. doi: 10.62438/tunismed.v102i10.4468.

Abstract

INTRODUCTION

Audiovisual distraction (AVD) is one of the non-pharmacological means of anxiety prevention. However, few studies have evaluated its perioperative effect in adults.

AIM

To evaluate the contribution of audio-visual distraction in the prevention of perioperative anxiety in adult patients proposed for surgery under spinal anesthesia.

METHODS

This was a prospective randomized controlled study lasting three months from July 1, 2021. We included ASA I to III over 18 years patients, proposed for visceral or orthopedic surgery under spinal anesthesia. We didn't include patients operated in lateral or prone positions or with a history of anxiety disorders or communication difficulties. 90 patients were randomized into two groups: a control group T and a group A who had an AVD throughout the operation. The primary outcome was anxiety as assessed by the visual analogue scale (VAS).

RESULTS

Demographic characteristics, Amsterdam preoperative anxiety and information scale (APAIS) and pain levels were comparable between the two groups. During the surgery, 22 (48.9 %) patients in group T versus 3 (6.7 %) in group A required Midazolam (p < 0.001). Anxiety assessed by VAS at the end of the act was lower in group A (p < 0.001). The pain levels also were lower in patients who received AVD (p = 0.004). A patient satisfaction score (Iowa Satisfaction with Anesthesia Scale French version) ≥ 5.4 was more frequently observed in group A (p < 0.001).

CONCLUSION

AVD reduced perioperative anxiety and decreased the use of midazolam during surgery performed under spinal anesthesia.

摘要

引言

视听分心(AVD)是预防焦虑的非药物手段之一。然而,很少有研究评估其在成人围手术期的效果。

目的

评估视听分心对接受脊髓麻醉手术的成年患者围手术期焦虑预防的作用。

方法

这是一项前瞻性随机对照研究,从2021年7月1日起持续三个月。我们纳入了18岁以上、拟接受脊髓麻醉下内脏或骨科手术的ASA I至III级患者。我们排除了侧卧位或俯卧位手术的患者,以及有焦虑症病史或沟通困难的患者。90名患者被随机分为两组:对照组T和在整个手术过程中接受AVD的A组。主要结局是通过视觉模拟量表(VAS)评估的焦虑。

结果

两组在人口统计学特征、阿姆斯特丹术前焦虑和信息量表(APAIS)以及疼痛水平方面具有可比性。在手术过程中,T组22名(48.9%)患者与A组3名(6.7%)患者需要使用咪达唑仑(p<0.001)。在手术结束时,A组通过VAS评估的焦虑较低(p<0.001)。接受AVD的患者疼痛水平也较低(p=0.004)。A组更频繁地观察到患者满意度评分(爱荷华麻醉满意度量表法语版)≥5.4(p<0.001)。

结论

AVD降低了围手术期焦虑,并减少了脊髓麻醉手术期间咪达唑仑的使用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3b4/11574372/ca70ab494e56/capture1.jpg

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