Preoperative Anxiety In Patients Research Articles

Effect of Weighted Blanket Versus Traditional Practices on Anxiety and Pain in Patients Undergoing Elective Surgery: A Multicenter Randomized Controlled Trial.

Perioperative anxiety is common in surgical patients and linked to poor outcomes. This multicenter randomized controlled trial assessed the effect of the use of a warm weighted blanket on presurgical anxiety and pain, as well as postsurgical restlessness, nausea, and vomiting. Levels of anxiety and pain were measured in adult patients using a 100-point visual analog scale before elective surgery. Patients received either a warm weighted blanket (n=74) or a traditional sheet or nonweighted blanket (n=74). Patients in the intervention group had significantly lower preoperative anxiety scores (mean [SD]=26.28 [25.75]) compared to the control group (mean [SD]=38.73 [30.55], P=.008). However, the intervention had no significant effect on presurgical pain or postsurgical nausea, vomiting, or restlessness. These results suggest that weighted blankets reduce preoperative anxiety in adult patients.

Comparison of the effects of two amino acids, Gamma-aminobutyric acid (GABA) and L-theanine, on sedation, anxiety, and cognition in preoperative surgical patients – A randomized controlled study

Abstract Background and Aims: Preoperational anxiety affects the outcome of anesthesia and surgery. Benzodiazepines impair psychomotor performance and cause excessive sedation. L-theanine is a unique amino acid found in green tea. It prevents stress, produces anxiolysis, modulates alpha activity, and provides beneficial effects on mental state, including sleep quality. Gamma-aminobutyric acid (GABA) is a non-proteinogenic amino acid and a phytochemical that is the main inhibitory neurotransmitter in the mammalian brain. It is beneficial in anxiety and stress regulation. Hence, alternative premedicants such as L-theanine and GABA will have a widespread appeal and are safer. The primary objective was to study and compare the effects of L-theanine and GABA on preoperative anxiety, sedation, and cognition in patients posted for major elective surgeries. The secondary objective was to study adverse reactions. Material and Methods: A total of 168 patients aged between 18 and 55 years, belonging to the American Society of Anesthesiologists physical status class I and II, and satisfying all inclusion criteria were randomly divided into three groups that received either oral L-theanine, oral GABA, or oral alprazolam 0.25 mg. The anxiety score, sedation score, and psychomotor and cognitive performance scores were noted 60 minutes before and after the administration of the drugs. Results: Alprazolam produced more sedation than GABA and L-theanine (P = 0.0001). Psychomotor and cognitive functions improved with L-theanine and GABA (P = 0.0001) and decreased with alprazolam (P = 0.0001). Conclusion: GABA and L-theanine result in effective preoperative anxiolysis with minimal sedation and improvement of cognitive skills.

Assessment of Preoperative Anxiety Utilizing Amsterdam Preoperative Anxiety and Information Scale in Patients Undergoing Intracranial Tumor Surgery: An Exploratory Study

Abstract Background Preoperative anxiety in neurosurgical patients is high due to life-threatening illness and uncertainty of the surgical outcome. This study assessed preoperative anxiety and its influencing factors in patients undergoing intracranial tumor surgeries utilizing the Amsterdam Preoperative Anxiety and Information Scale (APAIS). Methods One-hundred twenty patients, 18 to 65 years of age, of either sex, American Society of Anesthesiologists (ASA) grades I/II posted for elective craniotomy and tumor excision, were selected for the study. Various components of the APAIS were explained, and the level of anxiety and need for information were noted. The level of anxiety and depression by HADS (Hospital Anxiety and Depression Scale) score was also evaluated. Results The mean age was 38.00 ± 12.15 years. About 57.5% of the patients were male. Eighteen (15%) patients had an educational qualification of class 10, 60(50%) of 10 + 2, 36 (30%) were graduates, and 6 (5%) had a postgraduate qualification.The mean APAIS for total anxiety was 11.10 ± 1.79; the score for need for information was 6.28 ± 1.61. Mean total anxiety scores were higher in female patients (11.96 vs. 10.46, p < 0.001). Higher anxiety was observed in ASA status I patients (11.33 vs. 10.539 ASA I vs. II, p = 0.020). Significantly higher anxiety was observed in patients educated till class 10 (p = 0.012). A significantly higher need for information was observed in postgraduates (p = 0.012). Eighty (66.7%) patients had clinical anxiety, and 35 (29.2%) had clinical depression on the HADS score. Conclusion Neurosurgical patients have higher anxiety due to intracranial pathology, site of surgery, and unpredictability of outcome. Demographic and clinical variables do affect anxiety levels.

Effectiveness of Educational Videos on Reducing Anxiety in Pre-Anesthesian Patients

Surgery and anesthesia are actions that can cause problems for someone who will undergo them, one of the problems that is often found is anxiety. Several research results report that anxiety can affect 60-80% of patients undergoing surgery. Objective: To determine the effectiveness of health education using video media in reducing preoperative patient anxiety. Method:This research uses a pre-experimental method with one group pretest and posttest design. This research was conducted in March-April 2023 at Buleleng Regional Hospital. The sample in this study involved 42 patients undergoing elective surgery. The research instrument was a questionnaire sheet which was then analyzed using the Kolmogorov – Smirnov statistical test. Results:Providing complete anesthesia education was 42 (100.0%) respondentsn. The results of the pre-education research on gold were 23 (54.8%) respondents who were seriously anxious, 16 (38.1%) respondents were moderately anxious, 2 (4.8%) respondents were very anxious, 1 (2.4%) respondent was mildly anxious. The results of the post-education research were 25 (59.5%) respondents who were seriously anxious, 14 (33.3%) respondents were moderately anxious, 2 (4.8%) respondents were very anxious, and 1 (2.4%) respondent was mildly anxious. Conclusion:Effectiveness of educational videosanesthesia is able to increase patient understanding and knowledge so that it can reduce the anxiety level of pre-anesthesia patients at Buleleng Regional Hospital.

Effect of RARC-ERAS nursing program on clinical outcomes in patients undergoing RARC surgery: a retrospective, propensity matching study

Currently, there is no specific perioperative nursing standard for RARC based on the ERAS concept. This retrospective study investigates to analyze the effect of RARC-ERAS nursing program on VTE and other clinical outcomes in patients undergoing RARC surgery. This retrospective study included 216 patients undergoing RARC surgery From January 1, 2022 to December 30, 2023, and propensity score adjustment analysis was applied. The study compares a control group receiving traditional nursing and an observation group receiving RARC-ERAS nursing program. Perioperative variables and other postoperative complications were retrieved from the hospital medical records. After propensity score matching, there were no significant differences in the demographic and clinical characteristics between the two groups (p > 0.05). The ERAS group exhibited aa significantly higher rate of postoperative unobstructed venous blood flow in the lower extremities by color Doppler ultrasound as compared to the control group (94.6% VS 80.4%, p = 0.042). Before anesthesia induction, lower preoperative anxiety and surgical information needs scores were observed in the ERAS group than in the control group (p < 0.05). Compared to the control group, the ERAS group demonstrated a shorter surgical duration, a lower incidence of perioperative hypothermia, less time needed for getting out of bed, anal exhaust, and for defecation after returning to the ward (p < 0.05). RARC-ERAS nursing program significantly increased the rate of postoperative unobstructed venous blood flow in the lower extremities by color doppler ultrasound, lower preoperative anxiety and intraoperative hypothermia in patients undergoing RARC. This nursing approach presents a valuable strategy for enhancing patient outcomes and merits further exploration in clinical practice.Trial registration:ChiCTR2400081118; http://www.chictr.org.cn, Principal investigator: Mang-mang He, Date of registration: Feb 22, 2024.

Assessment of preoperative anxiety and negative automatic thoughts in patients waiting for corneal transplantation

Introduction and aim. In patients waiting for organ transplantation, increased waiting time can increase anxiety by creating negative automatic thoughts. The aim of this study is to examine the relationship between corneal transplant recipients’ negative automatic thoughts and anxiety before organ transplantation. Material and methods. The population of this correlational descriptive study consisted of 108 patients waiting for cornea transplantation in the Eye Bank unit of a hospital in the south east region of Türkiye. The data were obtained from the patients presented to the ophthalmology clinic for transplantation between September and December 2022. A patient information form, the Negative Automatic Thoughts Scale, and the Trait Anxiety Scale were used to collect the data. Percentage distribution, arithmetic mean, logistic regression and correlation analysis were used in the data analysis. Results. It was determined that the mean score of the negative automatic thoughts of the transplant patients participating in the study was 100.69±47.83, and the trait anxiety mean score was 53.06±6.07. There was a positive relationship between neg ative automatic thoughts and trait anxiety at a moderate level, which was statistically significant (p&lt;0.05, r=0.53). Conclusion. It was determined in the study that the patients’ negative automatic thoughts and trait anxiety were high, and their anxiety increased as the negative automatic thoughts increased.

Frequency Of Anxiety in Pre-Operative Surgical Patients in the Tertiary Care Hospitals, Karachi

Background: Preoperative anxiety significantly impacts patient outcomes and healthcare delivery, with varying degrees of prevalence reported globally. Understanding and managing this anxiety are crucial for improving surgical experiences and patient recovery. This study focuses on tertiary care hospitals in Karachi, aiming to elucidate the frequency and determinants of preoperative anxiety among elective surgery patients. Objective: To ascertain the prevalence of preoperative anxiety among patients awaiting elective surgeries in various surgical units of tertiary care hospitals in Karachi and to identify significant contributing factors. Methods: In a prospective cross-sectional design, 400 patients scheduled for elective surgeries across six surgical units were assessed using the Amsterdam Preoperative Anxiety and Information Scale (APAIS). SPSS version 24 facilitated the analysis, focusing on global anxiety prevalence and its associations with demographic and clinical variables. Results: The study revealed a 62.0% prevalence of preoperative global anxiety. The APAIS scores indicated higher anxiety related to the surgery (mean = 7.27 ± 2.31) compared to anesthesia (mean = 5.14 ± 2.35). Significant associations were found between anxiety levels and age groups (p=0.002), surgical procedures (p&lt;0.001), and type of anesthesia (p&lt;0.001). ENT and urology patients exhibited notably higher anxiety, at 75.0% and 68.0% respectively. Multivariate analysis demonstrated a significant impact of gender on preoperative anxiety, with females showing increased vulnerability [aOR 1.91 (95% CI 1.13-3.21); p=0.015]. Conclusion: Preoperative anxiety remains a prevalent concern, with female patients exhibiting higher levels of anxiety than their male counterparts. The findings advocate for targeted counseling and informational support for patients, especially females, prior to surgery and anesthesia consultations, underscoring the need for healthcare professionals to address and mitigate preoperative anxiety effectively.

Factors related to preoperative anxiety in older patients with sensory impairment: A cross-sectional study.

To identify the factors related to preoperative anxiety in older adults with sensory impairment. Descriptive quantitative research design. Study participants were 120 older adults admitted to a tertiary hospital in Seoul, South Korea to undergo eye or ear surgery. Data were collected from 11 February to 30 April 2023. The collected data were analysed using descriptive statistics, t-tests, ANOVA, and multiple regression analysis using SPSS 28.0. The study was reported following the STROBE checklist. Preoperative anxiety differed significantly according to gender (p = .002), average monthly household income (p < .001), subjective health status (p = .003), subjective vision loss (p = .004), one-sided or both-sided eye discomfort (p = .002), use of glasses (p = .010), subjective hearing loss (p = .022) and anxiety coping mechanisms (p < .001). The results of a multiple regression analysis on the significant variables identified that gender (β = .178, p = .036) and anxiety coping mechanisms (β = .336, p < .001) had the most significant effect on preoperative anxiety, with an explanatory power of 34.5%. The development and practical application of tailored nursing interventions catering to specific genders and anxiety coping mechanisms would contribute to reducing preoperative anxiety and providing efficient nursing care for older adults with sensory impairment.

Analysis of preoperative and postoperative depression and anxiety in patients with osteochondral lesions of the talus.

This study aims to investigate the psychological status of patients with Hepple V osteochondral lesions of the talus (OLT) and evaluate the effect of autologous osteoperiosteal transplantation (AOPT) on their psychological well-being. Fifty patients with Hepple V OLT who underwent AOPT at the Comprehensive Foot and Ankle Surgery Ward of Xi'an Honghui Hospital from November 2021 to May 2023 were included in this study. The patients were divided into two groups based on the presence or absence of preoperative symptoms of anxiety/depression. Group A comprised patients with preoperative symptoms, while Group B included patients without such symptoms. Preoperative and final follow-up assessments included the Hospital Anxiety and Depression Scale for evaluating anxiety and depression, the visual analogue scale for pain assessment, and the American Orthopaedic Foot and Ankle Society scores for assessing ankle and hindfoot function. Among the 50 Hepple V OLT patients who obtained complete follow-up, twenty-four had preoperative symptoms of anxiety/depression, with an incidence rate of up to 48%. Patients in Groups A and B showed significant improvement in all evaluation indexes after AOPT compared to the preoperative period, but the overall prognosis of Group A was poorer than that of Group B. AOPT can effectively improve patients' pain, functional activities, and psychological status, and there is a significant correlation between patients' preoperative psychological status and prognosis.

Effectiveness of Peer-Based and Conventional Video Education in Reducing Perioperative Depression and Anxiety Among Coronary Artery Bypass Grafting Patients: A Randomized Controlled Trial

PurposeDepression and anxiety are common comorbidities in patients undergoing coronary artery bypass grafting (CABG), with potential adverse effects on surgical outcomes. Effective interventions to reduce depression and anxiety in these patients are therefore warranted. This study investigated the effectiveness of peer-based video education compared to conventional video education in reducing perioperative depression and anxiety in CABG patients. DesignA three-arm, parallel, randomized, controlled trial design was employed. MethodsA total of 114 participants were randomly assigned to one of three groups (n=38 per group): standard education (control), conventional video education, and peer-based video education. State anxiety levels were measured using the Spielberger State Anxiety Questionnaire at one day before surgery (baseline), one hour before surgery, and four weeks after surgery. Depression levels were measured using the Beck Depression Inventory Short-Form (BDI-SF) at baseline and four weeks after surgery. Statistical analyses, including Chi-square, Fisher's exact test, one-way analysis of variance (ANOVA), and repeated measures ANOVA, were applied to analyze the collected data. FindingsBoth peer-based and conventional video education groups demonstrated lower preoperative anxiety levels compared to the control group. However, only the peer-based video education group exhibited a statistically significant difference (p < 0.05). Four weeks after surgery, anxiety and depression levels decreased in all participants compared to baseline, with no statistically significant differences among the three groups. ConclusionOur findings suggest that peer-based video education is more effective in controlling preoperative anxiety in patients undergoing CABG than conventional video education and standard education. Moreover, video-based education, whether conventional or peer-based, appears to be as effective as standard education in reducing anxiety and depression four weeks after CABG surgery. Further research is warranted to investigate the influence of content and presentation methods on patient outcomes and explore the potential long-term benefits of video-based education in promoting patient care.

Preoperative anxiety management in pediatric patients: a systemic review and meta-analysis of randomized controlled trials on the efficacy of distraction techniques.

This study addresses the pervasive issue of heightened preoperative anxiety in healthcare, particularly among pediatric patients. Recognizing the various sources of anxiety, we explored both pharmacological and nonpharmacological interventions. Focusing on distraction techniques, including active and passive forms, our meta-analysis aimed to provide comprehensive insights into their impact on preoperative anxiety in pediatric patients. Following the PRISMA and Cochrane guidelines, this meta-analysis and systematic review assessed the efficacy of pharmaceutical and distraction interventions in reducing pain and anxiety in pediatric surgery. This study was registered on PROSPERO (CRD42023449979). This meta-analysis, comprising 45 studies, investigated pharmaceutical interventions and distraction tactics in pediatric surgery. Risk of bias assessment revealed undisclosed risks in performance and detection bias. Distraction interventions significantly reduced preoperative anxiety compared to control groups, with notable heterogeneity. Comparison with Midazolam favored distraction techniques. Subgroup analysis highlighted varied efficacies among distraction methods, with a notable reduction in anxiety levels. Sensitivity analysis indicated stable results. However, publication bias was observed, suggesting a potential reporting bias. Our study confirms distraction techniques as safe and effective for reducing pediatric preoperative anxiety, offering a valuable alternative to pharmacological interventions. https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=449979, PROSPERO [CRD42023449979].

Audio-Visual Therapy for Anxiety of Preoperative Patients Sectio Caesarea in the Central Surgical Installation Room of Ajibarang Hospital

Sectio Caesarea (SC) is a surgical procedure in labor that can cause anxiety. These feelings can occur due to fear of death, failed medication and complications. One of the therapies to reduce anxiety of SC preoperative patients with audio-visual therapy. This study aims to determine the effect of audio-visual therapy on the anxiety of SC preoperative patients in the Central Surgical Installation Room (IBS) of Ajibarang Hospital. The study used quantitative methods with experimental design in the form of pre-experimental design one group pretest-posttest. The sample was mothers who will undergo SC in the IBS Room of Ajibarang Hospital, a total of 30 respondents with purposive sampling techniques. The research instrument used the APAIS questionnaire. Data were analyzed using the Wilcoxon test. The results of the study obtained a p value of 0.000 &lt; 0.05, so it can be concluded that there are differences in the anxiety level of SC preoperative patients before and after audiovisual therapy in the IBS Room of Ajibarang Hospital. In conclusion, there are differences in the level of anxiety before and after audiovisual therapy is given to the anxiety level of SC preoperative patients in the IBS Room of Ajibarang Hospital.

The Effect of Preoperative Education on Preoperative Anxiety in Patients Waiting for Surgery: A literature Review

Context: Among patients undergoing surgery, preoperative anxiety (PA) is one of the most common psychological problems that can negatively impact the patient's physical health and the operation's outcome. Preoperative patient education (PPE) is a way to reduce PA, which has many advantages over pharmaceutical methods. Therefore, this study aimed to evaluate the effectiveness of PPE on PA in patients who are candidates for surgery by reviewing similar previous studies. Evidence Acquisition: The data in this narrative review were collected by searching past studies in reliable international databases, including Web of Science, Science Direct, Scopus, PubMed, and Google Scholar, in the last two decades. In the first stage of the search, 248 articles and scientific reports were received, and then 30 articles were selected as final studies by considering the inclusion and exclusion criteria. Results: In most previous similar studies, PPE significantly reduced PA in patients who are candidates for surgery. However, the findings of a small number of studies also showed that PPE had little positive effect, no effect, or negative effect on PA control. There were different methods to provide information to patients before surgery, and the efficiency and application of each were different based on the demographic characteristics of the patients. Conclusions: Based on the findings, appropriate training methods can reduce the level of PA in patients who are candidates for surgery. However, in some past studies, providing information about the surgical procedure may increase patients' PA. Therefore, nurses or medical staff with more contact with patients are suggested to have sufficient experience and knowledge in providing information and choosing the training method for patients before surgery.

Music Therapy and Aromatherapy Intervention on Anxiety in Preoperative Laparotomy Digestive Surgery Patients: A Systematic Review

Laparotomy is a surgical procedure to open the abdominal cavity, with an incision in the abdominal wall to access the organs. Laparotomy can cause anxiety in the patient. Management that may be given to reduce anxiety is music therapy and aroma therapy. Both of these therapies stimulate the brain to change emotions. Anxiety before surgery has an impact on the results of surgery which can cause hypertension, increase heart rate, and can cause bleeding. This study aims to explain the effect of music therapy and aromatherapy interventions on anxiety in digestive surgery patients before laparotomy surgery. The research design used the Preferred Reporting Items for Systemic Review guidelines with an online literature search strategy using the Scopus, Science Direct, PubMed and ProQuest databases. The years of literature sources taken are 2014 to 2023. Research from 19 journals reviewed showed that there was an effect of a combination of music therapy and aromatherapy on anxiety in preoperative laparotomy digestive surgery patients. The articles reviewed were based on inclusion criteria. The results of the review of all articles showed that music therapy and aromatherapy were effective in overcoming anxiety in patients who were going to undergo laparotomy surgery. This intervention can reduce the impact or complications that may occur after laparotomy surgery. Music therapy and aromatherapy are effective interventions used as therapy to reduce anxiety levels before laparotomy surgery and can be used as independent nursing interventions that are easy and cheap to implement and have excellent benefits for patients.

Impact of Visual and Aural Education on the Anxiety Level of Patients Under Spinal Anesthesia for Preoperative Caesarean Section

Background: The implementation of Sectio Caesarea (SC) requires anesthesia to relieve pain in patients who will undergo surgical procedures. SC action can cause anxiety in pregnant women who will undergo surgery. Purpose: Knowing the effect of audiovisual education on the anxiety level of preoperative ectio caesarea patients with spinal anesthesia at RSUD dr. H. Soemarno Sosroatmodjo Tanjung Selor. Method: This research design uses a pre-experimental design with a Pre and post-test without control approach. Accidental sampling technique. The number of samples obtained was 40 respondents. Measurement of anxiety using the Amsterdam Preoperative Anxiety and Information Scale (APAIS) with audio visual education intervention. Findings: The age of the patients was mostly in the category of 20-35 years, 35 patients (87.5%) and the majority of parity with primiparous 24 patients (60%), Anxiety of preoperative cesarean section patients before giving audio visual education about cesarean section surgery with spinal anesthesia the majority with moderate anxiety 25 patients (62.5%), Anxiety of preoperative cesarean section patients after giving audio visual education about cesarean section surgery with spinal anesthesia the majority with not anxious or normal a total of 21 (52.5%). Conclusion: There is an effect of audio-visual education on the anxiety level of preoperative sectio caesarea patients with spinal anesthesia at RSUD dr. H. Soemarno Sosroatmodjo Tanjung.&#x0D;

THE RELATIONSHIP OF FAMILY SUPPORT WITH THE LEVEL OF PRE-ANESTHESIAN SECTIO PATIENTS IN THE HOSPITAL PEKALONGAN REGIONAL GENERAL

Background: Sectio Caesarea (SC) is a surgical procedure to save a mother and baby. Most SC preoperative patients experience mild and severe anxiety; this anxiety will affect the patient's recovery process. Anxious conditions cause vasoconstriction of blood vessels, so that blood supply to the heart decreases. One of the other factors causing anxiety in preoperative patients is family support. Families who always support the patient's recovery will be able to reduce patient anxiety. Objective: The purpose of this study was to determine the relationship between family support and the pre-anesthesia anxiety level of sectio-caesarea patients at Bendan Pekalongan Hospital. Methods: Using quantitative observational and analytic research methods with a cross-sectional approach. The place of research was in the reception room of IBS Bendan Pekalongan Hospital. sample 36 patients with consecutive sampling techniques. Data analysis in the form of bivariate data produces the frequency distribution and percentage of each variable. Results: The results of the correlation coefficient of -493** indicate that there is a fairly strong and significant correlation with a negative or unidirectional direction, meaning that the greater the level of family support, the lower the patient's anxiety level. Conclusion: The results of the spearman rank test analysis of 36 respondents showed a p value of 0.001, &lt;0.05, which means that there is a relationship between family support and the level of pre-anesthesia anxiety of Sectio Caesarea patients at Bendan Pekalongan Regional General Hospital.&#x0D; Keywords: Family support, anxiety level, and pre-anesthesia of Sectio Caesarea patient

Effective doses of midazolam oral solution for the prevention of preoperative anxiety in paediatric patients.

More than 60% children exhibit anxiety before undergoing an anesthetic-surgical procedure, particularly among pre-school paediatric patients. Oral midazolam can provide procedural sedation for children prior to anesthesia. However, extemporaneous solutions of midazolam are usually prepared from injectable drug solutions, leading to inconsistent efficacy due to variable preparation methods. Xiaoerjing® is the first commercially available oral formulation of midazolam for procedural sedation in children in China. Despite the recommended dosage range of 0.25-0.5 mg/kg, its effective dose is still largely unknown. To determine the 95% effective dose (ED95) of midazolam oral solution (Xiaoerjing®) for alleviating preoperative anxiety in children prior to mask induction of general anesthesia. The study included 61 children between the ages of 1 and 6 years undergoing elective surgery under general anesthesia. The first patient received a single dose of 0.5 mg/kg midazolam oral solution, which was adjusted for subsequent patients using the biased coin design method based on their response to the previous dose. Doses were increased or decreased at the rate of 0.1 mg/kg. An effective response was defined as having a modified Ramsay sedation score ≥3a, separation anxiety score ≤2, and mask acceptance score ≤2 during inhalational anesthesia induction. Fifty-six children were included in the final analysis. Of those, sedation was successful in 50 patients, with a median separation time of 15 (IQR: 25) min. Midazolam oral solution has an ED95 of 0.8254 mg/kg (95% CI: 0.6915-0.8700 mg/kg) for relieving preoperative anxiety in children. No adverse events occurred following drug administration. Midazolam oral solution is a safe and effective medication for relieving preoperative anxiety in children. The ED95 of a single oral dose of midazolam oral solution is 0.8254 mg/kg (95% CI: 0.6915-0.8700 mg/kg).

Exploring Novel Non-pharmacologic Approaches to Address Preoperative Anxiety and Postoperative Pain in Pediatric Patients Undergoing In-Patient Surgical Procedures: A Scoping Review.

The pediatric population is more prone to experiencing anxiety and fear before undergoing an inpatient surgical procedure than adults. Non-pharmaceutical interventions, such as music therapy and virtual reality programs, have shown significant promise in reducing the post-operative pain associated with pre-operative anxiety of patients and their caregivers. While there is evidence to support the use of non-pharmaceutical treatment in the mitigation of pre-operative anxiety, there are limited published reports of non-pharmacological interventions for pre-operative anxiety in children undergoing inpatient surgical procedures. The goal of this scoping review was to identify and classify specific non-pharmacological interventions utilized inpatient among children to improve pre-operative anxiety and post-operative complications inflicting pain. Comprehensive searches were conducted using Ovid Medline, Embase Emtree, CINAHL Complete, and COCHRANE Central databases. The articles had to be peer-reviewed, written in English, published between 2000-2022, and contain measurements of pre-operative anxiety and post-operative pain to be included in the scoping review. Articles that reported findings on patients younger than 18 undergoing elective and/or routine surgeries, excluding emergent surgical cases, were selected. After a systemized screening process, 9 articles were selected for the final review. The findings indicated that non-pharmacological interventions such as virtual reality, hypnosis, and clowns reduced pre-operative anxiety and post-operative pain in pediatric patients. This scoping review identified a wide range of non-pharmacological interventions to mitigate the post-operative effects of pre-operative anxiety among children, including but not limited to music, visual reality, and other holistic methods. More longitudinal studies are warranted to understand the specific interventions that may be the most efficacious.

Nursing interventions for the management of preoperative anxiety in the pediatric patient

Introduction: Preoperative anxiety in pediatric patients has a high prevalence, negatively affecting the perioperative process of children, increasing the possibility of complications and causing poor pain control. Objectives: Know the existing interventions to reduce preoperative anxiety in pediatric, to study the effectiveness of them and identify the factors that influence it. Methodology: A literature review was performed in three recognized databases between November and December 2022, using as search equation: (intervention) AND (preoperative anxiety) AND (children OR pediatric). The selected studies passed the appropriate methodological quality scale. Results: paciente y el nivel socioeconómico, sobre todo. También estarían implicados factores como el sexo del menor, la separación de los padres que supone la intervención, el aislamiento del entorno social, experiencias previas del menor con el ambiente sanitario/hospitalario y la falta de información acerca del proceso quirúrgico information through comics do not show clear efficacy. The child´s age, level of development and previous experience with the hospital environment influence the effectiveness of these interventions. Conclusion: Interventions that involve a high level of distraction, that provide information and help the child to become familiar with the environment, are the most effective to reduce anxiety in this type of patients, with virtual reality being the most effective in recent studies. In addition, taking into account the characteristics of each patient is crucial to the choice of these interventions and to achieve the greatest effectiveness.

Effect of meditation and relaxation therapy on preoperative anxiety and stress in oral squamous cell carcinoma patients scheduled for oral and maxillofacial surgery: An experimental study.

The diagnosis of oral squamous cell carcinoma [OSCC] and its treatment phase is emotionally demanding for the patient and challenging for the surgeon. The induction of stress and anxiety is unavoidable in these patients. It becomes very important for the patient to have psychological as well as physical stability during this treatment phase. Various studies have reported the beneficial effect of meditation along with relaxation therapy on healthy individuals but the beneficial effect of meditation and relaxation therapy [MRT] to reduce stress and anxiety preoperatively in OSCC patients has not been reported in scientific literature. The aim of this study was to study the effect of MRT on preoperative anxiety and stress in OSCC patients undergoing for oral and maxillofacial surgery. An experimental, parallel study design was carried out with randomization of patients into experimental[25] and control group[25] with allocation ratio 1:1 in 50 patients diagnosed with OSCC [stage II or III] scheduled for oral and maxillofacial surgery with general anesthesia. The biopsy which was the prerequisite for the diagnosis was taken. Twenty-one days before surgery in experimental group, patients were oriented about meditation and relaxation exercises. The reorientation of MRT was done from the day of admission twice a day till the day of surgery. Physiological parameters for stress and anxiety like heart rate [HR], blood pressure [BP], pulse rate [PR], and respiratory rate [RR] were evaluated on 1st day of MRT at 9 am and on the day of surgery. The serum cortisol which was quantitative parameter for stress was evaluated 1st day of MRT at 9 am fasting and on the day of surgery. The qualitative analysis for anxiety was done preoperatively using visual analog scale on the 1st day before MRT and compared with the values on the day of surgery after MRT at a specific time. Paired t-test analysis was used intragroup whereas unpaired t-test was used intergroup between experimental and control groups with significance at P = 0.05 and highly significant at P = 0.0001. The serum cortisol was significantly less in the experimental group over control group with t = 7.04 and P = 0.0001. The systolic and diastolic BP, pulse rate, respiratory rate, and anxiety in the experimental group reported significantly less rate compared to the control group with t = 5.66, t = 22.2, t = 11.93, t = 27.71, and P = 0.0001. In our study, MRT in the form of Sukhasana, Anulom Vilom, Omkar chanting, and Shavasana for 30 min twice daily has shown positive effect to reduce stress and anxiety. The serum cortisol as a quantitative parameter has been effectively evaluated in this benchmark study.