Treatment Of Preoperative Anxiety Research Articles

Deep brain stimulation of the subthalamic nucleus for primary Meige syndrome: clinical outcomes and predictive factors.

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has demonstrated efficacy against multiple types of dystonia, but only a few case reports and small-sample studies have investigated the clinical utility of STN-DBS for Meige syndrome, a rare but distressing form of craniofacial dystonia. Furthermore, the effects of DBS on critical neuropsychological sequelae, such as depression and anxiety, are rarely examined. In this study, the authors investigated the therapeutic efficacy of STN-DBS for both motor and psychiatric symptoms of Meige syndrome. The authors retrospectively reviewed consecutive patients with Meige syndrome receiving bilateral STN-DBS at their institution from January 2016 to June 2023. Motor performance and nonmotor features including mood, cognitive function, and quality of life (QOL) were evaluated using standardized rating scales at baseline and at final postoperative follow-up. Clinical and demographic factors influencing postoperative motor outcome were evaluated by uni- and multivariable linear regression models. Fifty-one patients were ultimately included, with a mean ± SD follow-up duration of 27.3 ± 18.0 months. The mean Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) movement score improved from 12.9 ± 5.2 before surgery to 5.3 ± 4.2 at the last follow-up (mean improvement 58.9%, p < 0.001) and the mean BFMDRS disability score improved from 5.6 ± 3.3 to 2.9 ± 2.9 (mean improvement 44.6%, p < 0.001). Hamilton Depression and Anxiety Rating Scale scores also improved by 35.3% and 34.2%, respectively, and the postoperative 36-item Short-Form Health Survey score indicated substantial QOL enhancement. Global cognition remained stable after treatment. Multiple linear regression analysis identified disease duration (β = -0.241, p = 0.027), preoperative anxiety severity (β = -0.386, p = 0.001), and volume of activated tissue within the dorsolateral (sensorimotor) STN (β = 0.483, p < 0.001) as independent predictors of motor outcome. These findings support STN-DBS as an effective and promising therapy for both motor and nonmotor symptoms of Meige syndrome. Timely diagnosis, treatment of preoperative anxiety, and precise electrode placement within the dorsolateral STN are essential for optimal clinical outcome.

Intranasal Dexmedetomidine for the Treatment of Pre-operative Anxiety and Insomnia: A Prospective, Randomized, Controlled, and Clinical Trial.

Background and ObjectiveSeveral patients with pre-operative anxiety and insomnia refuse to take sleeping pills because of the side effects of sleeping pills. This study aimed to evaluate the applicability of intranasal dexmedetomidine (DEX) in the treatment of pre-operative anxiety and insomnia.MethodsA total of 72 patients with insomnia and anxiety were randomly divided into two groups of intranasal DEX (n = 36) and intranasal normal saline (NS, n = 36). The primary outcomes included patients' time to fall asleep, total sleep time, insomnia severity index (ISI) after treatment, and satisfaction with the treatment effect. The secondary outcomes were mean arterial pressure (MAP), oxygen saturation (SPO2), heart rate (HR), Narcotrend index (NI) in the first 2 h of treatment, and the incidence of adverse events within 12 h after treatment.ResultsThe time to fall asleep (22.08 ± 3.95 min) and total sleep time (400.06 ± 28.84 min) in the DEX group were significantly different from those in the NS group [time to fall asleep, 89.31 ± 54.56 min; total sleep time (295.19 ± 73.51 min; P < 0.001)]. ISI after treatment in the DEX group was lower than that in the NS group (P < 0.001). Satisfaction with the treatment effect was better in the DEX group than that in the NS group (P < 0.001). The general vital signs in the two groups were stable during the treatment. The drowsiness rate in the NS group was higher than that in the DEX group (P < 0.001).ConclusionIntranasal DEX can significantly improve pre-operative anxiety and insomnia.Clinical Trial RegistrationThis study was registered on Chinese Clinical Trial Registry (http://www.chictr.org.cn/searchproj.aspx, ChiCTR2100044747).

Auricular Acupuncture for Preoperative Anxiety-Protocol of Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: Preoperative anxiety causes profound psychological and physiological reactions that may lead to a worse postoperative recovery, higher intensity of acute and persistent postsurgical pain and impaired quality of life in the postoperative period. Previous randomized controlled trials (RCTs) suggest that auricular acupuncture (AA) is safe and effective in the treatment of preoperative anxiety; however there is a lack of systematic evidence on this topic. Therefore, this protocol was developed following the PRISMA guidelines to adequately evaluate the existing literature regarding the value of AA for the reduction in anxiety in patients in a preoperative setting, compared to other forms of acupuncture, pharmacological, or no control interventions and measured with questionnaires regarding anxiety and fear. Methods: The following databases will be searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. RCTs will be included if an abstract is available in English. Data collection and analysis will be conducted by two reviewers independently. Quality and risk assessment of included studies will be done using the Cochrane 5.1.0 handbook criteria and meta-analysis of effectiveness and symptom scores will be conducted using the statistical software RevMan V.5.3. Conclusions: This systematic review will evaluate the efficacy and safety of AA for preoperative anxiety. Since all data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. The results may be published in a peer-reviewed journal or be presented in relevant conferences. Registration number: PROSPERO ID CRD42020.

A randomized controlled study examining a novel binaural beat technique for treatment of preoperative anxiety in a group of women undergoing elective caesarean section

Importance Attention is being focused on improving mothers’ positive experiences of childbirth while reducing the negative ones. Cesarean section is a known factor able to increase maternal anxiety. Objective To determine whether a new binaural beat-based technique can reduce the preoperative discomfort of the elective surgical patient. Methods Prospective, randomized double-blind controlled study: 60 women scheduled to undergo elective cesarean section. Women with a low risk pregnancy were recruited and enrolled at the time of the "37 weeks" visit. Exclusion criteria were: psychiatric disorders, neurological impairment, epilepsy, deafness, use of drugs/alcohol during pregnancy, insufficient reading level. Participants will be contestually allocated to one of three groups according to a predetermined computer-generated random sequence: (1) "binaural" group, (2) "normal music" group, and (3) "control" group. Participants of groups 1 and 2 will be unaware of the type of audio heard. Intervention According to the allocation arm, participants were asked to listen an engineered audio track (binaural beat arm) created with the novel algorithm "Dynamic Spectrum Phase Shift" (DMSPS), or an identical soundtrack without DMSPS in it (music arm), or no specific intervention, representing standard practice. The feeling of anxiety has been measured by the State-Trait Anxiety Inventory (STAI-Y) questionnaire. Conclusions and Relevance: Binaural beat audio created with DMSPS algorithm provides superior changes in reported anxiety in comparison to normal music and above all to standard care. This technique does not need extra staff or extra staying time for the patients, so it could be a cost-effective way to manage preoperative anxiety in women undergoing elective cesarean section, with a potential impact to the mother’s positive experiences and care of the newborn. The EudraCT number: 2019-000743-27

Auricular Acupuncture for Exam Anxiety in Medical Students-A Randomized Crossover Investigation.

Auricular acupuncture (AA) is effective in the treatment of preoperative anxiety. The aim was to investigate whether AA can reduce exam anxiety as compared to placebo and no intervention. Forty-four medical students were randomized to receive AA, placebo, or no intervention in a crossover manner and subsequently completed three comparable oral anatomy exams with an interval of 1 month between the exams/interventions. AA was applied using indwelling fixed needles bilaterally at points MA-IC1, MA-TF1, MA-SC, MA-AT1 and MA-TG one day prior to each exam. Placebo needles were used as control. Levels of anxiety were measured using a visual analogue scale before and after each intervention as well as before each exam. Additional measures included the State-Trait-Anxiety Inventory, duration of sleep at night, blood pressure, heart rate and the extent of participant blinding. All included participants finished the study. Anxiety levels were reduced after AA and placebo intervention compared to baseline and the no intervention condition (p < 0.003). AA was better at reducing anxiety than placebo in the evening before the exam (p = 0.018). Participants were able to distinguish between AA and placebo intervention. Both AA and placebo interventions reduced exam anxiety in medical students. The superiority of AA over placebo may be due to insufficient blinding of participants.

Photos and music provide affordable treatment for pre-operative anxiety

Photos and music provide affordable treatment for pre-operative anxiety

Music Interventions for the Treatment of Preoperative Anxiety

The majority of surgical patients feel anxious prior to anesthesia or sedation. Health care professionals recognize that this preoperative anxiety can take its toll on the physiological and emotional states of patients, potentially resulting in an increased need for sedatives or anti-anxiety medications, difficulty with anesthesia or sedation, more severe postoperative pain and subsequent need for pharmaceutical interventions, and delayed recovery and discharge. Music interventions are an effective, noninvasive way to relieve and prevent the negative effects of preoperative anxiety.

Melatonin in Surgery and Critical Care Medicine

Administration of exogenous melatonin in surgical and critical care patients has been investigated for various clinical purposes. Studies have demonstrated that melatonin can be used for treatment of preoperative anxiety. The analgesic effect of melatonin is well documented in experimental studies, but still needs to be established further in human clinical studies. The sleep-regulating effects of melatonin in surgical and critical care patients remain unclear. Melatonin has been shown to reduce emergence delirium in the early postoperative period, but no evidence exists in relation to postoperative and intensive care delirium. Limited evidence exists with respect to reduction of oxidative stress in surgical patients. Melatonin has been shown to improve outcome in experimental sepsis models, but still needs to be documented further in human clinical studies. Mechanisms of actions need to be clarified and most importantly dose-response relationships should to be established within the specific procedures and indications. Finally, paramount issues remain in relation to administration form, dosage, timing of administration, and pharmacokinetics of melatonin in surgical and critical care patients.

Preoperative Anxiety in Adolescents Undergoing Surgery

Summary Objectives: The purpose of this study was to conduct a prospective assessment of preoperative anxiety in adolescents undergoing surgery. Aim: To systematically conduct a multimodal evaluation of preoperative anxiety in adolescents undergoing surgery. Background: The existing literature on preoperative anxiety in children has overwhelmingly ignored adolescents in the surgical setting, yet adolescents may be at risk for under treatment of preoperative anxiety. Methods: A total of 59 adolescents aged 11–18 were recruited. Behavioral and physiological manifestations of anxiety were assessed with a visual analog scale and an ambulatory physiological data recorder that collected heart rate (HR), skin conductance level (SCL), and blood pressure data. Baseline emotional and behavioral functioning (child behavior checklist [CBCL]) as well as temperament (early adolescent temperament questionnaire-revised – parent version) and other potential risk factors were also assessed. Results: Over 80% of adolescents reported significant anxiety at the time of induction. Self-reported anxiety increased significantly at each time point (holding, separation from parents, and mask introduction), P = 0.001. Significant increases in both HR (P = 0.02) and SCL (P < 0.001) were found from holding to mask introduction. Several risk factors were found to predict higher anxiety at mask introduction, including baseline anxiety and depression (CBCL, Internalizing, P = 0.04), somatizing problems (P = 0.05), and fearful temperament (P = 0.03). Conclusions: A large proportion of adolescents experience significant anxiety that increases from the preoperative holding area to anesthesia induction. Underlying baseline anxiety and depression as well somatization and fearful temperament are predictors of this phenomenon.

Preoperative anxiety in adolescents undergoing surgery: a pilot study

The purpose of this study was to conduct a prospective assessment of preoperative anxiety in adolescents undergoing surgery. To systematically conduct a multimodal evaluation of preoperative anxiety in adolescents undergoing surgery. The existing literature on preoperative anxiety in children has overwhelmingly ignored adolescents in the surgical setting, yet adolescents may be at risk for undertreatment of preoperative anxiety. A total of 59 adolescents aged 11-18 were recruited. Behavioral and physiological manifestations of anxiety were assessed with a visual analog scale and an ambulatory physiological data recorder that collected heart rate (HR), skin conductance level (SCL), and blood pressure data. Baseline emotional and behavioral functioning (child behavior checklist [CBCL]) as well as temperament (early adolescent temperament questionnaire-revised--parent version) and other potential risk factors were also assessed. Over 80% of adolescents reported significant anxiety at the time of induction. Self-reported anxiety increased significantly at each time point (holding, separation from parents, and mask introduction), P=0.001. Significant increases in both HR (P=0.02) and SCL (P<0.001) were found from holding to mask introduction. Several risk factors were found to predict higher anxiety at mask introduction, including baseline anxiety and depression (CBCL, Internalizing, P=0.04), somatizing problems (P=0.05), and fearful temperament (P=0.03). A large proportion of adolescents experience significant anxiety that increases from the preoperative holding area to anesthesia induction. Underlying baseline anxiety and depression as well somatization and fearful temperament are predictors of this phenomenon.

Functional Anatomy of Humor: Positive Affect and Chronic Mental Illness

Functional Anatomy of Humor: Positive Affect and Chronic Mental Illness

Clown Doctors as a Treatment for Preoperative Anxiety in Children: A Randomized, Prospective Study

The induction of anesthesia is one of the most stressful moments for a child who must undergo surgery: it is estimated that 60% of children suffer anxiety in the preoperative period. Preoperative anxiety is characterized by subjective feelings of tension, apprehension, nervousness, and worry. These reactions reflect the child's fear of separation from parents and home environment, as well as of loss of control, unfamiliar routines, surgical instruments, and hospital procedures. High levels of anxiety have been identified as predictors of postoperative troubles that can persist for 6 months after the procedure. Both behavioral and pharmacologic interventions are available to treat preoperative anxiety in children. The aim of this study was to investigate the effects of the presence of clowns on a child's preoperative anxiety during the induction of anesthesia and on the parent who accompanies him/her until he/she is asleep. The sample was composed of 40 subjects (5-12 years of age) who had to undergo minor day surgery and were assigned randomly to the clown group (N = 20), in which the children were accompanied in the preoperative room by the clowns and a parent, or the control group (N = 20), in which the children were accompanied by only 1 of his/her parents. The anxiety of the children in the preoperative period was measured through the Modified Yale Preoperative Anxiety Scale instrument (observational behavioral checklist to measure the state anxiety of young children), and the anxiety of the parents was measured with the State-Trait Anxiety Inventory (Y-1/Y-2) instrument (self-report anxiety behavioral instrument that measures trait/baseline and state/situational anxiety in adults). In addition, a questionnaire for health professionals was developed to obtain their opinion about the presence of clowns during the induction of anesthesia, and a self-evaluation form was developed to be filled out by the clowns themselves about their interactions with the child. The clown group was significantly less anxious during the induction of anesthesia compared with the control group. In the control group there was an increased level of anxiety in the induction room in comparison to in the waiting room; in the clown group anxiety was not significantly different in the 2 locations. The questionnaire for health professionals indicated that the clowns were a benefit to the child, but the majority of the staff was opposed to continuing the program because of perceived interference with the procedures of the operating room. The correlation between the scores of the form to self-evaluate the effectiveness of the clowns and of the Modified Yale Preoperative Anxiety Scale is significant for both the waiting room and induction room. This study shows that the presence of clowns during the induction of anesthesia, together with the child's parents, was an effective intervention for managing children's and parents' anxiety during the preoperative period. We would encourage the promotion of this form of distraction therapy in the treatment of children requiring surgery, but the resistance of medical personnel make it very difficult to insert this program in the activity of the operating room.

Interactive Music Therapy as a Treatment for Preoperative Anxiety in Children

Survey of Anesthesiology: February 2005 - Volume 49 - Issue 1 - p 28-29 doi: 10.1097/01.sa.0000151221.29512.ad

Room F, 10/16/2000 2: 00 PM - 4: 00 PM (PS) Auricular Acupuncture is a Potential Treatment for Preoperative Anxiety

<b>Room F, 10/16/2000 2: 00 PM - 4: 00 PM (PS) Auricular Acupuncture is a Potential Treatment for Preoperative Anxiety</b>