Impact of Premedication on Preoperative Anxiety in Females with Gynecological Diseases
https://doi.org/10.15360/1813-9779-2007-4-65-69
Abstract
Objective: to study preoperative psychoemotional, autonomic, and hematodynamic responses in patients to develop criteria for evaluating the efficiency of premedication.
Subjects and methods. Sixty gynecological patients (mean age 38.5±1.1 years), who were being prepared for elective surgery, were examined. According to the results of an integrative anxiety test, the patients were divided into 3 groups in relation to the level of personality anxiety. The three-stage study was conducted to evaluate systemic circulation by the results of impedance rheography and by the state of the autonom-ic nervous system, as evidenced by variational pulsometry.
Results. Preoperatively, the patients showed varying personality anxiety that further formed the psychoemotional features of their response to an impending operation. Situational anxiety components, such as a phobic element and emotional discomfort, should be also regarded as an informative criterion for the adequacy of premedication. Psychoemotional and autonomic changes were more pronounced in Group 3 patients who were prone to the development of decompensation of adaptive mechanisms due to their personality typological traits.
Conclusion. Premedication involving only narcotic analgesics and antihistamines does not limit the overac-tivation of the sympathetic part of the autonomic nervous system on the eve of the forthcoming operation.
About the Authors
I. G. BobrinskayaV. M. Yaltonsky
S. S. Khaikin
O. A. Bykova
References
1. Москалева М. А., Согомонян К. А. Омегаметрия в прогнозировании тревожно-депрессивных состояний у гастроэнтерологических больных в предоперационном периоде. Вестн. интенс. Терапии 1999; 5—6: 155—157.
2. Бредихин А. Ю. Оценка эффективности премедикации и ее оптимизация с позиций современной анестезиологии: автореф. дис….канд. мед. наук. Оренбург; 1996.
3. Гинзбург С. Г. Клинико физиологическое обоснование эффективности различных вариантов премедикации у больных с заболеваниями и повреждениями позвоночника: автореф. дис….канд. мед. наук. М.; 1992.
4. Муронов А. Е., Исмаилов Н. В. Эффект премедикации в формировании механизмов адекватности анестезии. Вестн. интенс. Терапии 1999; 5—6: 79—83.
5. Малышев Ю. П. Оптимизация анестезиологического обеспечения длительных операций в абдоминальной хирургии: автореф. дис….канд. мед. наук. М.; 2001.
6. Finley G. A., Stewart S. H., Buffett Jerrott S. et al. High levels of impulsivity may contraindicate midazolam premedication in children. Can. J. Anaesth. 2006; 53 (1): 73—78.
7. Pekcan M., Celebioglu B., Demir B. et al. The effect of premedication on preoperative anxiety. Middle East J. Anesthesiol. 2005; 15 (5): 271—274.
8. Ornaque I., Carrero E., Villalonga A. et al. Study of presurgical anxiety in urologic, gynecologic, and ophthalmologic surgery as a function of the administration or non administration of anxiolytic premedication. Rev. Esp. Anestesiol. reanim. 2000; 47 (4): 151—156.
9. Осипова Н. А., Абузарова Г. Р. Третий международный конгресс «Всемирный институт боли» (аналитический обзор). Анестезиология и реаниматология 2005; 5: 73—76.
10. Бизюк А. П., Вассерман Л. И., Иовлев Б. В. Применение интегративного теста тревожности (ИТТ). Методические рекомендации. СПб.; 1997. 23.
Review
For citations:
Bobrinskaya I.G., Yaltonsky V.M., Khaikin S.S., Bykova O.A. Impact of Premedication on Preoperative Anxiety in Females with Gynecological Diseases. General Reanimatology. 2007;3(4):65-69. (In Russ.) https://doi.org/10.15360/1813-9779-2007-4-65-69