不同麻醉应用对烧伤患者情绪、抑郁和焦虑水平的影响

IF 1.5 4区 医学 Q3 CRITICAL CARE MEDICINE Journal of Burn Care & Research Pub Date : 2024-11-14 DOI:10.1093/jbcr/irae105
Ayça Tuba Dumanlı Özcan, Betül Akaycan, Serdar Süleyman Can, Özlem Karakaya, Emine Sönmez, Ahmet Çınar Yastı, Orhan Kanbak
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引用次数: 0

摘要

对烧伤患者进行充分有效的疼痛管理和预防抑郁至关重要。本研究旨在探讨氯胺酮镇静对烧伤患者在重症监护室术后随访期间的情绪障碍、抑郁、焦虑和自杀的影响。本研究的对象年龄在18至65岁之间,属于ASA I-II级,具有基本的沟通能力,无确诊精神病史,无神经精神或认知障碍或相关治疗史。研究对象为 67 名患者。预吸氧后,全身麻醉组使用 2 毫克/千克静脉注射异丙酚和 1 微克/千克静脉注射芬太尼进行麻醉诱导。继续使用 0.3-0.5 微克/千克/分钟瑞芬太尼、2% 七氟醚、50% 空气、50% 氧气的混合麻醉。镇静组在诱导时使用 1 微克/千克静脉注射芬太尼和 1 毫克/千克静脉注射氯胺酮;必要时加入 30-50 毫克静脉注射丙泊酚维持麻醉。蒙哥马利-阿斯伯格抑郁评定量表(MADRS)、汉密尔顿焦虑评定量表(HAM-A)和贝克自杀意念量表(BSSI)均由精神科医生在术前和术后第一天实施。在组内评估中,镇静麻醉组的 MADRS 值在麻醉后(11.63±5.49)明显低于麻醉前(14.44±7.22)(P < 0.001)。麻醉后,两组患者的 HAM-A 评分均有明显下降。在使用 BSSI 的所有评估中,没有发现患者有自杀倾向。烧伤患者由于所经历的创伤,极有可能出现抑郁、焦虑症和自杀倾向。对于这些患者,使用氯胺酮进行镇静麻醉可能会减少术后的负面情绪、抑郁、焦虑和自杀倾向。
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Effects of Different Anesthesia Applications on Mood, Depression, and Anxiety Levels in Burn Patients.

Adequate and effective pain management and prevention of depression are essential in patients with burns. This study aims to explore the effects of ketamine sedation in patients with burns in terms of mood disorders, depression, anxiety, and suicidality during postoperative follow-up in the intensive care unit. This study targeted subjects aged 18-65 years, in the ASA I-II class, with basic communication skills, no history of diagnosed mental illness, and no history of neuropsychiatric or cognitive disorders or related treatment. The study was conducted on 67 patients. After preoxygenation, anesthesia induction was practiced with 2 mg/kg intravenous (IV) propofol and 1 mcg/kg IV fentanyl in the general anesthesia group. Anesthesia was continued with a mixture of 0.3-0.5 mcg/kg/min remifentanil, 2% sevoflurane, 50% air, and 50% oxygen. In the sedation group, 1 mcg/kg IV fentanyl and 1 mg/kg IV ketamine were administered at induction; anesthesia was maintained by adding 30-50 mg IV propofol if necessary. The Montgomery-Asberg Depression Rating Scale (MADRS), Hamilton Anxiety Rating Scale (HAM-A), and Beck Scale for Suicidal Ideation (BSSI) have been administered via way of means of a psychiatrist preoperatively and on the primary postoperative day. In intragroup evaluations, MADRS values for the sedation anesthesia group decreased statistically significantly after the anesthesia (11.63 ± 5.49) compared to the preanesthesia period (14.44 ± 7.22) (P < .001). HAM-A scores of both anesthesia groups decreased statistically significantly after anesthesia. No patient was found to have suicidal ideation in all evaluations in which BSSI was used. Patients with burns may have a high potential for depression, anxiety disorders, and suicidal tendencies due to the trauma they have experienced. In these patients, sedation anesthesia with ketamine may reduce negative mood, depression, anxiety, and suicidal tendencies in the postoperative period.

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来源期刊
CiteScore
2.60
自引率
21.40%
发文量
535
审稿时长
4-8 weeks
期刊介绍: Journal of Burn Care & Research provides the latest information on advances in burn prevention, research, education, delivery of acute care, and research to all members of the burn care team. As the official publication of the American Burn Association, this is the only U.S. journal devoted exclusively to the treatment and research of patients with burns. Original, peer-reviewed articles present the latest information on surgical procedures, acute care, reconstruction, burn prevention, and research and education. Other topics include physical therapy/occupational therapy, nutrition, current events in the evolving healthcare debate, and reports on the newest computer software for diagnostics and treatment. The Journal serves all burn care specialists, from physicians, nurses, and physical and occupational therapists to psychologists, counselors, and researchers.
期刊最新文献
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