Key result
Regional anesthesia combined with sedation and regional anesthesia alone demonstrated significant preoperative correlations between situational anxiety and cortisol levels (r=0.6, p=0.002 and r=0.7, p=0.00006).
Why the study?
The choice of an adequate anesthesia method for surgical treatment of lower limb injuries remains a critical task, each with specific advantages and disadvantages.
Does combined regional anesthesia with sedation compared to regional anesthesia alone improve stress laboratory findings and psychoemotional state in patients undergoing surgery for lower limb injuries?
Observational (n=60)
Does combined regional anesthesia with sedation compared to regional anesthesia alone improve stress laboratory findings and psychoemotional state in patients undergoing surgery for lower limb injuries?
Combined regional anesthesia with sedation may be preferable to regional anesthesia alone for managing perioperative stress and anxiety in patients undergoing lower limb surgery.
Answers are grounded in this paper and cite their sources.
Anxiety-cortisol correlations observed with regional anesthesia; leaves open sedation's benefit on stress, requiring prospective validation.
The choice of an adequate method of anesthesia for surgical treatment of lower limbs injuries remains a critical task today. Each method applied in this treatment has its advantages and disadvantages. In recent years, regional anesthesia has been the preferential method. The aim of the study. To study the stress laboratory findings and their relation to the patients’ psychoemotional state in perioperative period while performing regional and combined anesthesia. Material and methods. It was studied 60 patients aged 18-59 years, who underwent metal osteosynthesis operations due to lower limbs injuries. Surgical treatment was performed under regional anesthesia and regional anesthesia followed by sedation. The patients of both groups were conducted heamodynamics monitoring and determined the intensity of pain in accordance with visual analogue scale and stress indicators with a laboratory method. The psychoemotional state was assessed with the Spielberger-Hanin anxiety scale. Results. According to the study it was determined, that in patients, who were planned to have surgery, significant psychoemotional stress and stress concentration of hormones in the blood and their interrelation was discovered. Patients about before surgery had a relationship between situational anxiety and cortisol r=0.7; p=0.00006 in group I; r=0.6; p=0.002 in the second group. The relationship between VAS and cortisol r=0.5; p=0.04 in groups I and II. After surgery, the connection was in group I patients between situational anxiety and cortisol r=0.4; p=0.02; the relationship between insulin and the HOMA index r=0.5; p=0.01. Conclusions. Before the operation, all patients revealed significant psychoemotional stress and stressful changes in the concentration of hormones in the blood. Reliably pronounced dynamics of the indicators was with the use of combined conduction anaesthesia. Thus, the performed study allows to recommend combined regional anesthesia as the method of anesthesia choice, particularly in patients with high anxiety.
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E. Yu. Korobko (2020) conducted an observational in Lower limbs injuries requiring metal osteosynthesis (n=60). Regional anesthesia followed by sedation vs. Regional anesthesia alone was evaluated on Relationship between situational anxiety and cortisol levels before surgery (r=0.6, p=0.002). Regional anesthesia combined with sedation and regional anesthesia alone demonstrated significant preoperative correlations between situational anxiety and cortisol levels (r=0.6, p=0.002 and r=0.7, p=0.00006).
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