Anxiety evaluation in Nepalese adult patients awaiting cardiac surgery

Sigdel, Shailendra; Ozaki, Akihiko; Basnet, Madindra; Kobashi, Yurie; Pradhan, B.; Higuchi, Asaka; Uprety, Anup

doi:10.1097/md.0000000000019302

Cited by 12 publications

(7 citation statements)

References 28 publications

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“…A score of 10 or more on the APAIS for combined anxiety[ 1 2 4 5 ] was used to define anxiety, according to prior publications. [ 3 11 ] Continuous parameters which were normally distributed were represented by the mean ± SD and were compared between those with a combined anxiety score of less than or equal to 10, and those with a score greater than 10, utilizing a two-sample Student’s t -test. Numbers and percentages represented qualitative parameters such as sex, marital status, education level, socioeconomic strata, type of surgery, past mental or nervous disorder, history of anesthetic administration, and were analyzed using the Chi-square or Fisher’s exact assessment.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of Postoperative Pain After Cardiothoracic Surgery in Patients With and Without Significant Preoperative Anxiety: A Prospective Observational Study

Shreya,

Rath,

Parida

et al. 2024

Annals of Cardiac Anaesthesia

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Background and Aims: Anxiety plays a distressing role in cardiothoracic operations. It may trigger hemodynamic instability, increased morbidity, and very crucially, postoperative pain and analgesic use. Our aim is to look at the association between anxiety, postoperative pain, and analgesic use. Materials and Methods: One hundred and twenty-two patients scheduled for cardiothoracic surgeries were asked questions according to the Amsterdam Preoperative Anxiety and Information Scale (APAIS), the evening prior to the surgery. Different factors that could affect anxiety perioperatively were recorded through the patient’s hospital records. The visual analog score (VAS) was recorded at arrival in the ICU after surgery. Paracetamol (1 g) and Inj Tramadol (1 mg/kg) were administered as postoperative analgesia. Additional fentanyl boluses (1 mcg/kg) were administered whenever the VAS exceeded 4. Analgesic doses were documented. All the data were then analyzed statistically. Results: Preoperative anxiety was recorded in 63.9% of the 122 subjects included in the study, with younger patients and patients with very low socioeconomic status being the majority. VAS, at 20 and 24 hrs of assessment, was higher in both groups, and there was a statistically significant difference, with patients that were preoperatively anxious, recording higher VAS scores. Postoperative analgesic doses were also significantly higher for patients with anxiety. Conclusions: This clinical trial demonstrated that greater than 60% of the participants presented with preoperative anxiety, the majority being young participants. Lower socioeconomic status is also a risk factor for preoperative anxiety. Patients who suffered from preoperative anxiety are more likely to have greater pain scores and analgesic needs during postsurgical assessment.

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Section: Methodsmentioning

confidence: 99%

Evaluation of Postoperative Pain After Cardiothoracic Surgery in Patients With and Without Significant Preoperative Anxiety: A Prospective Observational Study

Shreya,

Rath,

Parida

et al. 2024

Annals of Cardiac Anaesthesia

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“…In 1996, the Dutch group Moermann developed APAIS [ 4 ] which includes a six items questionnaire that includes four questions regarding fear of anesthesia and surgery and two questions regarding the need for information. Questions based on APAIS were translated into Nepalese, validated, and used among the Nepalese population as in study by Sigdel et al [ 5 ] Five-point Likert scale is used to grade the answers, 1 = not at all to 5 = extremely.…”

Section: Methods and Methodologymentioning

confidence: 99%

Section: Anxietymentioning

confidence: 99%

“…Anxiety is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral factors [ 5 ]. Perioperative anxiety can be defined as an unpleasant feeling of fear and concern and is commonly found among patients in need of or about to undergo surgical procedures [ 5 ]. Unfamiliar environments in hospitals and thoughts of undergoing a surgical procedure in operation theater without the presence of surrogates can cause anxiety.…”

Section: Anxietymentioning

confidence: 99%

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Role of pre-operative counseling with NSQIP surgical risk calculator in the surgical patients

Khadka,

Sharma,

Bhattarai

et al. 2024

Surgery Open Science

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“…Almost 30% of patients undergoing a TKA surgery experience psychological distresses preoperatively(6). These emotional conditions negatively impact postoperative pain and opioid consumption, post-surgical complications rate, recovery time and re-hospitalization rate (7)(8)(9)(10)(11)(12)(13)(14)(15)(16). Although preliminary data demonstrate that advances in perioperative medicine such as the use of multimodal and multidisciplinary interventions appear to control perioperative surgical stress response and improve postoperative outcomes, this is insu cient.…”

Section: Introductionmentioning

confidence: 99%

SuRxgWell: Study Protocol for a Randomized Controlled Trial of Telemedicine-based digital Cognitive Behavioral Intervention for high Anxiety and Depression Among Patients Undergoing Elective Hip and Knee Replacement surgery

Kaynar,

Lin,

Sanchez

et al. 2023

Preprint

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Background Mood disorders (anxiety, depression) and catastrophizing, lead to increased post-operative pain perception, decreased engagement with physical activity, and increased resource utilization. Studies on perioperative psychological assessment and treatment are scarce. Digital cognitive behavioral intervention (dCBI) such as RxWelläreduces depression in patients with inflammatory bowel disease. We hypothesize that SuRxgWell, the surgical adaptation of RxWellä, can improve preoperative mood disorders and subsequently reduce postoperative pain and opioid requirement in patients undergoing primary total hip and knee arthroplasty (THA, TKA). Methods This randomized, controlled trial will enroll primary and unilateral THA or TKA patients with anxiety and/or depression symptoms before surgery to receive the SuRxgWell. After an informed consent, subjects will be screened using the PROMIS Anxiety/Depression questionnaires. Subjects with a T-score of ≥ 60 will be randomized to either usual care (control group) or SuRxgWell dCBI pre- and perioperative cognitive behavioral intervention via RxWell plus usual care (intervention group). Control group will receive information on how to locate tools to address mood disorders, whereas the intervention group will have access to SuRxgWell 1 month prior to surgery and up to 3 months thereafter. The allocation will be 3:1 (intervention: control). Investigators will be blinded, but research coordinators and subjects will not. The primary outcome will be day of surgery anxiety or depression symptoms measured with the PROMIS Anxiety/Depression, GAD-7, and PHQ-8. Secondary endpoints include sleep disturbance, fatigue, ability to participate in social roles, pain interference, cognitive function, pain catastrophizing, and physical function as well as preoperative and postoperative pain scores, pain medication usage, orthopedic functional recovery at baseline, day of surgery, and 1, 2, and 3 months after the surgery. Subjects will complete a GAD-7 and PHQ-8 questionnaires bi-weekly. Data about RxWell usage and engagement, postsurgical complications, and resource utilization will be recorded. The primary outcome will be analyzed with intention-to-treat estimates and tested using independent two sample t-tests. Discussion We will evaluate dCBI as a perioperative tool to improve anxiety and depression before and after major orthopedic surgery. If effective, this might have important clinical implications towards improving outcomes. Trial Registration clinicaltrials.gov, NCT05658796. Registered 21 December 2022. https://clinicaltrials.gov/ct2/show/NCT05658796

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Anxiety evaluation in Nepalese adult patients awaiting cardiac surgery

Abstract: Supplemental Digital Content is available in the text

Cited by 12 publications

References 28 publications

Evaluation of Postoperative Pain After Cardiothoracic Surgery in Patients With and Without Significant Preoperative Anxiety: A Prospective Observational Study

Evaluation of Postoperative Pain After Cardiothoracic Surgery in Patients With and Without Significant Preoperative Anxiety: A Prospective Observational Study

Role of pre-operative counseling with NSQIP surgical risk calculator in the surgical patients

SuRxgWell: Study Protocol for a Randomized Controlled Trial of Telemedicine-based digital Cognitive Behavioral Intervention for high Anxiety and Depression Among Patients Undergoing Elective Hip and Knee Replacement surgery

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