Lorazepam does not improve the quality of recovery in day-case surgery patients

Mijderwijk, Hendrik-Jan; Beek, S. van der; Klimek, Markus; Duivenvoorden, Hugo J.; Grüne, Frank; Stolker, Robert Jan

doi:10.1097/eja.0b013e328361d395

Cited by 40 publications

(50 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Further, some pharmacological interventions (e.g. lorazepam and pregabalin), intended to treat anxiety, fail to decrease preoperative anxiety and postoperative pain [17,18]. In the ICU environment, deep levels of sedation potentially lead to increased mortality and lengths of stay [19].…”

Section: Introductionmentioning

confidence: 99%

Can hypnosis and virtual reality reduce anxiety, pain and fatigue among patients who undergo cardiac surgery: a randomised controlled trial

Rousseaux

Faymonville

Nyssen

et al. 2020

Trials

View full text Add to dashboard Cite

Background: Different non-pharmacological techniques, including hypnosis and virtual reality (VR) are currently used as complementary tools in the treatment of anxiety, acute and chronic pain. A new technique called virtual reality hypnosis (VRH), which encompasses a combination of both tools, is regularly used although its benefits and underlying mechanisms remain unknown to date. With the goal to improve our understanding of VRH combination effects, it is necessary to conduct randomised and controlled research trials in order to understand their clinical interest and potential benefits.Methods: Patients (n = 100) undergoing cardiac surgery at the Liège University Hospital will be randomly assigned to one of four conditions (control, hypnosis, VR or VRH). Each patient will receive two sessions of one of the techniques: one the day before the surgery and one the day after. Physiological assessments will be made on the monitor and patients will rate their levels of anxiety, fatigue, pain, absorption and dissociation. Discussion: This study will help to expand knowledge on the application of virtual reality, hypnosis and VRH in the specific context of cardiac and intensive care procedures, and the influence of these non-pharmacological techniques on patient's anxiety, fatigue, pain and phenomenological experience.

show abstract

Section: Introductionmentioning

confidence: 99%

Can hypnosis and virtual reality reduce anxiety, pain and fatigue among patients who undergo cardiac surgery: a randomised controlled trial

Rousseaux

Faymonville

Nyssen

et al. 2020

Trials

View full text Add to dashboard Cite

show abstract

“…2 Of these, 383 patients completed the measurements on the seventh day after surgery. We calculated percentages and means as measures of a central tendency for determinants and outcome variables in these 383 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Second, in the original RCT, patients were excluded due to use of psychopharmaceuticals or because they were undergoing certain surgical procedures, e.g., abortion, which were stressful for these patients. 2 It is plausible that these patients may be more susceptible to the psychological events that could be elicited by a surgical procedure. Therefore, we expect that the actual percentage of vulnerable patients in ambulatory surgery may be higher than 36%.…”

Section: Future Considerationsmentioning

confidence: 99%

“…This study comprises data from a larger randomized clinical trial published previously, 2 and parts of this Methods section were adapted to address the different objectives of the current study.…”

Section: Study Populationmentioning

confidence: 99%

“…1 Quality of life, along with endpoints like pain and transient loss of function, has become a more important clinical endpoint in ambulatory surgery, which is dominated by psychological outcome parameters such as anxiety, aggression, fatigue, and depression. 2 Over the last decades, prediction research has been performed on somatic outcomes in ambulatory surgery patients, 1,3-5 but prediction models tailored to psychological outcomes are lacking. Nevertheless, poor psychological outcomes in patients can have negative socioeconomic consequences due to prolonged convalescence that delays a return to normal activities and work.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical prediction model to identify vulnerable patients in ambulatory surgery: towards optimal medical decision-making

Mijderwijk

Stolker

Duivenvoorden

et al. 2016

Can J Anesth/J Can Anesth

Self Cite

View full text Add to dashboard Cite

Background Ambulatory surgery patients are at risk of adverse psychological outcomes such as anxiety, aggression, fatigue, and depression. We developed and validated a clinical prediction model to identify patients who were vulnerable to these psychological outcome parameters. Methods We prospectively assessed 383 mixed ambulatory surgery patients for psychological vulnerability, defined as the presence of anxiety (state/trait), aggression (state/trait), fatigue, and depression seven days after surgery. Three psychological vulnerability categories were considered-i.e., none, one, or multiple poor scores, defined as a score exceeding one standard deviation above the mean for each single outcome according to normative data. The following determinants were assessed preoperatively: sociodemographic (age, sex, level of education, employment status, marital status, having children, religion, nationality), medical (heart rate and body mass index), and psychological variables (self-esteem and self-efficacy), in addition to anxiety, aggression, fatigue, and depression. A prediction model was constructed using ordinal polytomous logistic regression analysis, and bootstrapping was applied for internal validation. The ordinal c-index (ORC) quantified the discriminative ability of the model, in addition to measures for overall model performance (Nagelkerke's R 2 ). Results In this population, 137 (36%) patients were identified as being psychologically vulnerable after surgery for at least one of the psychological outcomes. The most parsimonious and optimal prediction model combined sociodemographic variables (level of education, having children, and nationality) with psychological variables (trait anxiety, state/trait aggression, fatigue, and depression). Model performance was promising: R 2 = 30% and ORC = 0.76 after correction for optimism.

show abstract

Enhanced Recovery Program in the Ambulatory Surgery Setting

Joshi

2019

Manual of Practice Management for Ambulatory Surgery Centers

View full text Add to dashboard Cite

Lorazepam does not improve the quality of recovery in day-case surgery patients

Abstract: ClinicalTrials.gov identifier: NCT01441843.

Cited by 40 publications

References 30 publications

Can hypnosis and virtual reality reduce anxiety, pain and fatigue among patients who undergo cardiac surgery: a randomised controlled trial

Can hypnosis and virtual reality reduce anxiety, pain and fatigue among patients who undergo cardiac surgery: a randomised controlled trial

Clinical prediction model to identify vulnerable patients in ambulatory surgery: towards optimal medical decision-making

Enhanced Recovery Program in the Ambulatory Surgery Setting

Contact Info

Product

Resources

About