Xi-Rong Li1, Wen-Hao Zhang2, John P Williams3, Tong Li4, Jian-Hu Yuan5, Yun Du6, Jin-De Liu7, Zhe Wu2, Zhao-Yang Xiao8, Rui Zhang9, Guo-Kai Liu10, Guan-Rong Zheng11, Dong-Ya Zhang12, Hong Ma13, Qu-Lian Guo14, Jian-Xiong An15. 1. Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China; School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China. 2. Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China. 3. Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. 4. Department of Pain, Lanzhou Maternity and Child Healthcare Hospital, Lanzhou, Gansu, China. 5. Department of Anesthesiology, Beijing Rectum Hospital, Beijing, China. 6. Department of Anesthesiology, University of Chinese Academy of Sciences Affiliated Chongqing Hospital, Chongqing, China. 7. Department of Anesthesiology, University of Chinese Academy of Sciences Affiliated North China Hospital, Renqiu, Hebei, China. 8. Department of Anesthesiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China. 9. School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China. 10. Department of Anesthesiology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China. 11. Department of Anesthesiology, Shengli Oilfield Central Hospital, Dongying, Shangdong, China. 12. Department of Anesthesiology, Beijing Huaxin Hospital, The First Affiliated Hospital of Tsinghua University, Beijing, China. 13. Department of Anesthesiology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China. 14. Department of Anesthesiology, Xiangya Hospital of Central South University, Changsha, Hunan, China. 15. Department of Anesthesiology, Pain and Sleep Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China; School of Anesthesiology, Weifang Medical University, Weifang, Shangdong, China. Electronic address: anjianxiong@yahoo.com.
Abstract
OBJECTIVES: To describe patient characteristics associated with preoperative anxiety and subsequently assess the relationship between preoperative anxiety and postoperative anxiety, pain, sleep quality, nausea and vomiting. METHODS: The study collected data from patients undergoing elective operation from 12 hospitals in China. The State-Trait Anxiety Inventory (STAI) and the Athens Insomnia Scale (AIS) were used to assess anxiety and sleep quality before surgery. Evaluations of anxiety, pain, sleep quality, nausea and vomiting were quantified using the Visual Analogue Scale on postoperative days 1 and 2. RESULTS: Data from 997 patients were analyzed. Preoperatively, 258 (25.9%) patients had high anxiety (STAI-State>44). Multivariate analyses showed a significant relationship between high anxiety and female gender (OR: 1.66, 95% CI: 1.08-2.57, p = 0.02), highly invasive surgery (OR: 2.29, 95% CI: 1.29-4.06, p = 0.005), higher trait anxiety (OR: 1.24, 95% CI: 1.20-1.28, p < 0.001) and insomnia (AIS ≥ 6, OR: 1.79, 95% CI: 1.17-2.76, p = 0.008). Preoperative anxiety demonstrated a negative correlation with postoperative anxiety following highly invasive surgery; this became a positive relationship following less invasive surgery. Preoperative anxiety was also positively related to postoperative pain and poor sleep quality. The correlation between preoperative anxiety and postoperative nausea and vomiting was not statistically significant. CONCLUSION: Female gender, highly invasive surgery, higher trait anxiety and insomnia are independent risk factors for high preoperative anxiety. Surgical invasiveness influences association between pre- and postoperative anxiety. Higher preoperative anxiety is related to poorer sleep quality and more severe pain postoperatively.
OBJECTIVES: To describe patient characteristics associated with preoperative anxiety and subsequently assess the relationship between preoperative anxiety and postoperative anxiety, pain, sleep quality, nausea and vomiting. METHODS: The study collected data from patients undergoing elective operation from 12 hospitals in China. The State-Trait Anxiety Inventory (STAI) and the Athens Insomnia Scale (AIS) were used to assess anxiety and sleep quality before surgery. Evaluations of anxiety, pain, sleep quality, nausea and vomiting were quantified using the Visual Analogue Scale on postoperative days 1 and 2. RESULTS: Data from 997 patients were analyzed. Preoperatively, 258 (25.9%) patients had high anxiety (STAI-State>44). Multivariate analyses showed a significant relationship between high anxiety and female gender (OR: 1.66, 95% CI: 1.08-2.57, p = 0.02), highly invasive surgery (OR: 2.29, 95% CI: 1.29-4.06, p = 0.005), higher trait anxiety (OR: 1.24, 95% CI: 1.20-1.28, p < 0.001) and insomnia (AIS ≥ 6, OR: 1.79, 95% CI: 1.17-2.76, p = 0.008). Preoperative anxiety demonstrated a negative correlation with postoperative anxiety following highly invasive surgery; this became a positive relationship following less invasive surgery. Preoperative anxiety was also positively related to postoperative pain and poor sleep quality. The correlation between preoperative anxiety and postoperative nausea and vomiting was not statistically significant. CONCLUSION: Female gender, highly invasive surgery, higher trait anxiety and insomnia are independent risk factors for high preoperative anxiety. Surgical invasiveness influences association between pre- and postoperative anxiety. Higher preoperative anxiety is related to poorer sleep quality and more severe pain postoperatively.
Authors: Weiwei Liu; Rui Xu; Ji'e Jia; Yilei Shen; Wenxian Li; Lulong Bo Journal: Int J Environ Res Public Health Date: 2022-08-09 Impact factor: 4.614