Ayça Tuba Dumanlı Özcan, Betül Akaycan, Serdar Süleyman Can, Özlem Karakaya, Emine Sönmez, Ahmet Çınar Yastı, Orhan Kanbak
{"title":"不同麻醉应用对烧伤患者情绪、抑郁和焦虑水平的影响","authors":"Ayça Tuba Dumanlı Özcan, Betül Akaycan, Serdar Süleyman Can, Özlem Karakaya, Emine Sönmez, Ahmet Çınar Yastı, Orhan Kanbak","doi":"10.1093/jbcr/irae105","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":15205,"journal":{"name":"Journal of Burn Care & Research","volume":" ","pages":"1623-1626"},"PeriodicalIF":1.5000,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Effects of Different Anesthesia Applications on Mood, Depression, and Anxiety Levels in Burn Patients.\",\"authors\":\"Ayça Tuba Dumanlı Özcan, Betül Akaycan, Serdar Süleyman Can, Özlem Karakaya, Emine Sönmez, Ahmet Çınar Yastı, Orhan Kanbak\",\"doi\":\"10.1093/jbcr/irae105\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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. 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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.
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.