Postoperative Effects of Preoperative Anxiety

NCT04432558 | Completed FDA Drug

• 1 other identifier: K17/24
• Study Type: observational
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

INTRODUCTION Patients who will have obesity surgery have about %48 psychiatric illnesses like anxiety disorder. Studies which analyze the relationship between preoperative anxiety level and postoperative pain had reported conflicting results. The aim of this study is to search the relationship between preoperative anxiety level and postoperative pain and analgesic consumption in patients who had laparoscopic sleeve gastrectomy surgery. MATERIAL AND METHODS Our prospective double-blind study is planned to require 86 female patients aged between 18-65 years old, American Society of Anesthesiologists (ASA) I-II and Body mass index (BMI) ≥40 kg/m\^2. Patients having a psychiatric or neurologic disease, brain damage, using psychiatric medications (antidepressants, anxiolytics) and chronic alcohol, known allergy to medications used in the study protocol, inability to provide informed consent will be excluded. Patients will be wanted to fill the Spielberger's State-Trait Anxiety Inventory the night before the surgery. The analgesic consumption of the patients will be recorded by evaluating the pain with Visual analog scale (VAS) and sedation status with Ramsay's sedation scale in the 1st, 4th, 12th and 24th hour of postoperative period. EXPECTATIONS AND SCIENTIFIC CONTRIBUTIONS More satisfying postoperative analgesia may be provided in this group of patients by determining correlation between preoperative anxiety level and postoperative pain and analgesic consumption in patients who had laparoscopic sleeve gastrectomy. Morbidity rate related with pain may be decreased and patient satisfaction may be increased.

Conditions

Anxiety; Pain, Postoperative

Keywords

Preoperative anxiety level; Postoperative pain; Laparoscopic sleeve gastrectomy

Outcome Measures

Primary Outcomes (1)

• Does Preoperative anxiety level effect postoperative pain?

  More satisfying postoperative analgesia may be provided in this group of patients by determining correlation between preoperative anxiety level and postoperative pain and analgesic consumption in patients who had laparoscopic sleeve gastrectomy.Patients will be wanted to fill the Spielberger's State-Trait Anxiety Inventory the night before the surgery. The analgesic consumption of the patients will be recorded by evaluating the pain with Visual analog scale (VAS) and sedation status with Ramsay's sedation scale in the 1st, 4th, 12th and 24th hour of postoperative period.

  5 years

Study Arms (2)

Preoperative anxiety level

Diagnostic Test: Spielberger's State-Trait Anxiety Inventory

Postoperative pain and analgesic consumption

Other: Visual analog scale, Ramsay's sedation scale; Drug: Tramadol, paracetamol, diclofenac sodium

Interventions

Spielberger's State-Trait Anxiety Inventory DIAGNOSTIC_TEST

Patients will be wanted to fill the Spielberger's State-Trait Anxiety Inventory the night before the surgery.

Preoperative anxiety level

Visual analog scale, Ramsay's sedation scale OTHER

The analgesic consumption of the patients will be recorded by evaluating the pain with VAS (Visual analog scale) and sedation status with Ramsay's sedation scale in the 1st, 4th, 12th and 24th hour of postoperative period.

Postoperative pain and analgesic consumption

Tramadol, paracetamol, diclofenac sodium DRUG

The analgesic consumption of the patients will be recorded

Postoperative pain and analgesic consumption

Eligibility Criteria

• Age: 18 Years - 65 Years
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Female patients aged between 18-65 years old, ASA I-II, which BMI ≥35 kg/m\^2 and have bariatric surgical indications because of morbid (type III) obesity

You may qualify if:

• Female patients aged between 18-65 years old
• ASA I-II
• BMI ≥35 kg/m\^2

You may not qualify if:

• Having a psychiatric or neurologic disease
• Brain damage
• Using psychiatric medications (antidepressants, anxiolytics) and chronic alcohol
• Known allergy to medications used in the study protocol

Sponsors & Collaborators

• Baskent University: lead

Study Sites (1)

Baskent University Zubeyde Hanim Practice and Research Center

Izmir, Karşıyaka, 35540, Turkey (Türkiye)

Location

Related Publications (28)

• Jawaid M, Mushtaq A, Mukhtar S, Khan Z. Preoperative anxiety before elective surgery. Neurosciences (Riyadh). 2007 Apr;12(2):145-8.

  PMID: 21857597 BACKGROUND

• Akinsulore A, Owojuyigbe AM, Faponle AF, Fatoye FO. ASSESSMENT OF PREOPERATIVE AND POSTOPERATIVE ANXIETY AMONG ELECTIVE MAJOR SURGERY PATIENTS IN A TERTIARY HOSPITAL IN NIGERIA. Middle East J Anaesthesiol. 2015 Jun;23(2):235-40.

  PMID: 26442401 BACKGROUND

• de Zwaan M, Enderle J, Wagner S, Muhlhans B, Ditzen B, Gefeller O, Mitchell JE, Muller A. Anxiety and depression in bariatric surgery patients: a prospective, follow-up study using structured clinical interviews. J Affect Disord. 2011 Sep;133(1-2):61-8. doi: 10.1016/j.jad.2011.03.025. Epub 2011 Apr 17.

  PMID: 21501874 BACKGROUND

• Edwards-Hampton SA, Madan A, Wedin S, Borckardt JJ, Crowley N, Byrne KT. A closer look at the nature of anxiety in weight loss surgery candidates. Int J Psychiatry Med. 2014;47(2):105-13. doi: 10.2190/PM.47.2.b.

  PMID: 25084797 BACKGROUND

• Clarke H, Kirkham KR, Orser BA, Katznelson R, Mitsakakis N, Ko R, Snyman A, Ma M, Katz J. Gabapentin reduces preoperative anxiety and pain catastrophizing in highly anxious patients prior to major surgery: a blinded randomized placebo-controlled trial. Can J Anaesth. 2013 May;60(5):432-43. doi: 10.1007/s12630-013-9890-1. Epub 2013 Feb 2.

  PMID: 23377862 BACKGROUND

• Robleda G, Sillero-Sillero A, Puig T, Gich I, Banos JE. Influence of preoperative emotional state on postoperative pain following orthopedic and trauma surgery. Rev Lat Am Enfermagem. 2014 Oct;22(5):785-91. doi: 10.1590/0104-1169.0118.2481.

  PMID: 25493674 BACKGROUND

• Raichle KA, Osborne TL, Jensen MP, Ehde DM, Smith DG, Robinson LR. Preoperative state anxiety, acute postoperative pain, and analgesic use in persons undergoing lower limb amputation. Clin J Pain. 2015 Aug;31(8):699-706. doi: 10.1097/AJP.0000000000000150.

  PMID: 26153780 BACKGROUND

• Petrovic NM, Milovanovic DR, Ignjatovic Ristic D, Riznic N, Ristic B, Stepanovic Z. Factors associated with severe postoperative pain in patients with total hip arthroplasty. Acta Orthop Traumatol Turc. 2014;48(6):615-22. doi: 10.3944/AOTT.2014.14.0177.

  PMID: 25637724 BACKGROUND

• Ali A, Altun D, Oguz BH, Ilhan M, Demircan F, Koltka K. The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy. J Anesth. 2014 Apr;28(2):222-7. doi: 10.1007/s00540-013-1712-7. No abstract available.

  PMID: 24077858 BACKGROUND

• Aouad MT, Kanazi GE, Malek K, Tamim H, Zahreddine L, Kaddoum RN. Predictors of postoperative pain and analgesic requirements following abdominal hysterectomy: an observational study. J Anesth. 2016 Feb;30(1):72-9. doi: 10.1007/s00540-015-2090-0. Epub 2015 Oct 24.

  PMID: 26499321 BACKGROUND

• Bradshaw P, Hariharan S, Chen D. Does preoperative psychological status of patients affect postoperative pain? A prospective study from the Caribbean. Br J Pain. 2016 May;10(2):108-15. doi: 10.1177/2049463716635680. Epub 2016 Mar 2.

  PMID: 27551421 BACKGROUND

• De Cosmo G, Congedo E, Lai C, Primieri P, Dottarelli A, Aceto P. Preoperative psychologic and demographic predictors of pain perception and tramadol consumption using intravenous patient-controlled analgesia. Clin J Pain. 2008 Jun;24(5):399-405. doi: 10.1097/AJP.0b013e3181671a08.

  PMID: 18496304 BACKGROUND

• Kain ZN, Sevarino F, Alexander GM, Pincus S, Mayes LC. Preoperative anxiety and postoperative pain in women undergoing hysterectomy. A repeated-measures design. J Psychosom Res. 2000 Dec;49(6):417-22. doi: 10.1016/s0022-3999(00)00189-6.

  PMID: 11182434 BACKGROUND

• Polomano RC, Heffner SM, Reck DL, Gelnett CM, French D. Evidence for opioid variability, Part 2: Psychosocial influences. Semin Perioper Nurs. 2001 Oct;10(4):159-66.

  PMID: 15129613 BACKGROUND

• Caumo W, Hidalgo MP, Schmidt AP, Iwamoto CW, Adamatti LC, Bergmann J, Ferreira MB. Effect of pre-operative anxiolysis on postoperative pain response in patients undergoing total abdominal hysterectomy. Anaesthesia. 2002 Aug;57(8):740-6. doi: 10.1046/j.1365-2044.2002.02690.x.

  PMID: 12133084 BACKGROUND

• Ozalp G, Sarioglu R, Tuncel G, Aslan K, Kadiogullari N. Preoperative emotional states in patients with breast cancer and postoperative pain. Acta Anaesthesiol Scand. 2003 Jan;47(1):26-9. doi: 10.1034/j.1399-6576.2003.470105.x.

  PMID: 12492793 BACKGROUND

• Feeney SL. The relationship between pain and negative affect in older adults: anxiety as a predictor of pain. J Anxiety Disord. 2004;18(6):733-44. doi: 10.1016/j.janxdis.2001.04.001.

  PMID: 15474849 BACKGROUND

• Kalkman JC, Visser K, Moen J, Bonsel JG, Grobbee ED, Moons MKG. Preoperative prediction of severe postoperative pain. Pain. 2003 Oct;105(3):415-423. doi: 10.1016/S0304-3959(03)00252-5.

  PMID: 14527702 BACKGROUND

• Hashimoto K, Iwayama S, Sano Y, Tatara T, Hirose M. Preoperative anxiety induces no clinically relevant effect on intraoperative nociceptive levels during breast surgery under general anesthesia. J Anesth. 2015 Dec;29(6):967-70. doi: 10.1007/s00540-015-2032-x. Epub 2015 May 21.

  PMID: 25995061 BACKGROUND

• Munafo MR, Stevenson J. Selective processing of threat-related cues in day surgery patients and prediction of post-operative pain. Br J Health Psychol. 2003 Nov;8(Pt 4):439-49. doi: 10.1348/135910703770238293.

  PMID: 14614791 BACKGROUND

• Kain ZN, Sevarino FB, Rinder C, Pincus S, Alexander GM, Ivy M, Heninger G. Preoperative anxiolysis and postoperative recovery in women undergoing abdominal hysterectomy. Anesthesiology. 2001 Mar;94(3):415-22. doi: 10.1097/00000542-200103000-00009.

  PMID: 11374599 BACKGROUND

• Papageorgiou GM, Papakonstantinou A, Mamplekou E, Terzis I, Melissas J. Pre- and postoperative psychological characteristics in morbidly obese patients. Obes Surg. 2002 Aug;12(4):534-9. doi: 10.1381/096089202762252307.

  PMID: 12194547 BACKGROUND

• Kim WS, Byeon GJ, Song BJ, Lee HJ. Availability of preoperative anxiety scale as a predictive factor for hemodynamic changes during induction of anesthesia. Korean J Anesthesiol. 2010 Apr;58(4):328-33. doi: 10.4097/kjae.2010.58.4.328. Epub 2010 Apr 28.

  PMID: 20508787 BACKGROUND

• 25. Öner N, Le Compte A. Durumluk-Sürekli Kaygı Envanteri El Kitabı, 1. Baskı, İstanbul, Boğaziçi Üniversitesi Yayınları, 1983; 1-26.

  BACKGROUND

• Aldrete JA. The post-anesthesia recovery score revisited. J Clin Anesth. 1995 Feb;7(1):89-91. doi: 10.1016/0952-8180(94)00001-k. No abstract available.

  PMID: 7772368 BACKGROUND

• Ramsay MA, Savege TM, Simpson BR, Goodwin R. Controlled sedation with alphaxalone-alphadolone. Br Med J. 1974 Jun 22;2(5920):656-9. doi: 10.1136/bmj.2.5920.656.

  PMID: 4835444 BACKGROUND

• 28. Karaman S, Dogru S, Karaman T, Tapar H, Sahin A, Arici S, Kaya Z, Suren M. Anesthesia management in laparoscopic bariatric surgery: Perioperative complications and outcomes in the third year of practice. JCEI 2014; 5: 200-5.

  BACKGROUND

• Vaughn F, Wichowski H, Bosworth G. Does preoperative anxiety level predict postoperative pain? AORN J. 2007 Mar;85(3):589-604. doi: 10.1016/S0001-2092(07)60130-6.

  PMID: 17352896 BACKGROUND

MeSH Terms

Conditions

Anxiety Disorders; Pain, Postoperative

Interventions

Tramadol; Acetaminophen; Diclofenac

Condition Hierarchy (Ancestors)

Mental Disorders; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Pain; Neurologic Manifestations; Signs and Symptoms

Intervention Hierarchy (Ancestors)

Cyclohexanols; Hexanols; Fatty Alcohols; Alcohols; Organic Chemicals; Dimethylamines; Methylamines; Amines; Lipids; Acetanilides; Anilides; Amides; Aniline Compounds; Phenylacetates; Acids, Carbocyclic; Carboxylic Acids

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 1 Day
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Medical doctor. Anaesthesia and reanimation specialist

Study Record Dates

• First Submitted: June 5, 2020
• First Posted: June 16, 2020
• Study Start: April 12, 2017
• Primary Completion: December 31, 2020
• Study Completion: January 30, 2021
• Last Updated: July 21, 2021

Record last verified: 2021-07

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)