目的研究全身麻醉腹部手术患者术前焦虑对术后疼痛、镇痛药用量及对术后镇痛满意度的影响。方法选取2009年8月-2010年4月68例ASAⅠ~Ⅱ级,拟行气管插管全身麻醉的腹部手术患者,术前采用状态-特质焦虑量表和抑郁评分量表进行焦虑程度的测评,术后观察VAS疼痛评分、总的镇痛药用量以及患者对镇痛的满意度,分析术前焦虑与术后VAS评分、镇痛药用量及镇痛满意度的相关性。结果 68例受试者术前STAI为50±13,BDI为16±13,术后VAS评分为4.0±2.1,术后24h镇痛药芬太尼的用量为(0.80±0.21)mg;术后镇痛药用量、患者镇痛满意度评分与术前STAI明显相关(r=0.68和r=-0.88,P〈0.01)。术后VAS评分与术前STAI及BDI也有一定的相关(r=0.35和r=0.3)。结论术前焦虑程度可以影响腹部手术患者对镇痛治疗的满意度,显著增加镇痛药用量。
Objective To investigate the effect of preoperative anxiety on postoperative pain,amount of analgesics and satisfaction of postoperative pain relief for patients undergoing abdominal surgery with general anesthesia.Methods A total of 68patients undergoing abdominal surgery with general anesthesia from August 2009 to April 2010were selected(ASA I-II).Preoperational anxiety levels were evaluated using State-Trait Anxiety Inventory(STAI)and Beck Depression Inventory(BDI)and postoperative VAS pain score,the total amount of analgesics used and satisfaction of pain relief were observed.The relationship between preoperative anxiety and postoperative VAS score,and total amount of analgesics used and satisfaction of pain relief were analyzed.Results The mean STAI and BDI of 68samples were 50±13and 16±13,respectively;the mean postoperative VAS was 4.0± 2.1,and the mean amount of analgesics fentanyl used in 24hours after the operation was(0.80±0.21)mg;the amount of post-operative analgesics used and the satisfaction of pain relief of the patients were found to be highly related to pre-operative STAI(r=0.68,-0.88;P〈0.01).Post-operative VAS score was also related to preoperational STAI and BDI(r=0.35,0.3).Conclusion Preoperative anxiety is closely related to the postoperative analgesics and satisfaction of pain relief for patients who had abdominal operation.Severe preoperative anxiety can significantly increase the amount of postoperative analgesics used and dissatisfaction of pain relief.