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采用新的多模式方法降低患者术前焦虑——一项叙述性综述

Decreasing Preoperative Anxiety in Patients with Newly Available Multimodal Approaches-A Narrative Review.

作者信息

Kisielewska Weronika, Kościółek Michał, Kowalczyk Weronika, Mitura Bernard, Mitura Lidia, Rogula Sylwester, Leszczyński Piotr Konrad, Antosik Katarzyna, Mitura Kryspin

机构信息

Faculty of Medical and Health Sciences, University in Siedlce, 08-110 Siedlce, Poland.

Third Department of Psychiatry, Institute of Psychiatry and Neurology, 02-957 Warsaw, Poland.

出版信息

J Clin Med. 2025 Apr 24;14(9):2940. doi: 10.3390/jcm14092940.

Abstract

Preoperative anxiety affects approximately 80% of adult patients; thus, identifying patients with excessive anxiety and implementing appropriate interventions can significantly reduce the risk of deterioration during the perioperative period. This narrative review presents current knowledge about pharmacological and nonpharmacological methods for reducing preoperative anxiety. Commonly used pharmacological options include benzodiazepines, ketamine, or fentanyl. Antidepressants have also been shown to be effective in alleviating symptoms, but they typically require four weeks to take effect. Establishment of supportive relationships with medical staff to help patients express their feelings have been shown to have a positive impact on anxiety reduction. Other nonpharmacological methods include the provision of information through informed consent forms, video materials, virtual reality, or the use of psychotherapeutic interventions such as breathing techniques, music therapy, or cognitive-behavioural therapy. Some studies suggest that essential oils may have a role in reducing perioperative anxiety. Nonpharmacological interventions can be used in patients of different ages. An increasing number of researchers advocate for a holistic approach that integrates less invasive and cost-effective interventions with conventional medicine. While various interventions have been proposed to manage preoperative anxiety, more research is needed to establish the most effective and feasible interventions for different patient populations.

摘要

术前焦虑影响约80%的成年患者;因此,识别焦虑过度的患者并实施适当干预措施可显著降低围手术期病情恶化的风险。这篇叙述性综述介绍了目前关于减轻术前焦虑的药物和非药物方法的知识。常用的药物选择包括苯二氮䓬类、氯胺酮或芬太尼。抗抑郁药也已被证明在缓解症状方面有效,但通常需要四周才能起效。与医护人员建立支持性的关系以帮助患者表达感受,已被证明对减轻焦虑有积极影响。其他非药物方法包括通过知情同意书、视频材料、虚拟现实提供信息,或使用心理治疗干预措施,如呼吸技巧、音乐疗法或认知行为疗法。一些研究表明,精油可能在减轻围手术期焦虑方面发挥作用。非药物干预措施可用于不同年龄段的患者。越来越多的研究人员主张采用一种整体方法,将侵入性较小且成本效益高的干预措施与传统医学相结合。虽然已经提出了各种干预措施来管理术前焦虑,但仍需要更多研究来确定针对不同患者群体最有效和可行的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f06/12072431/eb05ef0f1960/jcm-14-02940-g001.jpg

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