Shuqing Liang, Shuai Li, Zhao Zhong, Qichen Luo, Cai Nie, Donghua Hu, Yalan Li
{"title":"利多卡因-普利卡因乳膏联合或不联合雷马唑仑对脊柱麻醉患者 VAS 和 APAIS 焦虑评分的影响","authors":"Shuqing Liang, Shuai Li, Zhao Zhong, Qichen Luo, Cai Nie, Donghua Hu, Yalan Li","doi":"10.2147/dddt.s468486","DOIUrl":null,"url":null,"abstract":"<strong>Purpose:</strong> This study aimed to investigate patients’ expectative pain of spinal anesthesia puncture and anxiety pre-anesthesia, and to examine the effect of lidocaine-prilocaine cream and remimazolam prior to spinal anesthesia puncture on pain relief and anxiety release.<br/><strong>Methods:</strong> Patients undergoing spinal anesthesia were divided into control, lidocaine-prilocaine cream, and lidocaine-prilocaine cream with remimazolam groups. A questionnaire consisting of The Amsterdam Preoperative Anxiety and Information Scale (APAIS) and patient’s concerns and Visual Analog Scale (VAS) was used to evaluate patient’s anxiety and pain. The primary outcomes were differences in VAS and anxiety scores. Patient’s spinal anesthesia-related concerns, advent events and hemodynamic index were also recorded.<br/><strong>Results:</strong> The expected spinal anesthesia puncture pain was 5.34± 0.27 and anxiety scores before spinal anesthesia was 10.88 ± 0.64. A statistically significant positive correlation of 31.3% was detected between VAS and APAIS scores (r = 0.313; P=0.003). The VAS score at the time of puncture decreased by 29.7% (3.78± 0.40, P=0.001) in lidocaine-prilocaine cream group and 29.2% (3.75± 0.39, P=0.001) in lidocaine-prilocaine cream with remimazolam group compared with the expected VAS score. Lidocaine-prilocaine cream combined with or without remimazolam reduced the percentage of moderate pain (21.4% and 31.3% vs 50.0%, P=0.0001) and increased mild pain (60.7% vs 59.4% vs 22.7%, P=0.03). Anxiety score in lidocaine-prilocaine cream group was reduced by 2.84 (8.04± 0.76 vs 10.88 ± 0.46, P=0.05) when compared with pre-anesthesia. Concerns about postoperative pain (P=0.03) and fear of the needle or intervention (P=0.000) both decreased post-anesthesia among groups.<br/><strong>Conclusion:</strong> Approximately half of the patients scheduled for spinal anesthesia experienced a moderate level of preoperative anxiety. The patient’s pain expectation from the spinal anesthesia puncture was moderate, which was higher than the actual pain. Lidocaine-prilocaine cream with or without remimazolam sedative before spinal anesthesia puncture reduced the patient’s pain and anxiety scores after surgery.<br/><br/><strong>Keywords:</strong> preoperative anxiety, APAIS, spinal anesthesia, lidocaine-prilocaine, remimazolam<br/>","PeriodicalId":11290,"journal":{"name":"Drug Design, Development and Therapy","volume":null,"pages":null},"PeriodicalIF":4.7000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Effect of Lidocaine-Prilocaine Cream Combined with or Without Remimazolam on VAS and APAIS Anxiety Score in Patient Undergoing Spinal Anesthesia\",\"authors\":\"Shuqing Liang, Shuai Li, Zhao Zhong, Qichen Luo, Cai Nie, Donghua Hu, Yalan Li\",\"doi\":\"10.2147/dddt.s468486\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<strong>Purpose:</strong> This study aimed to investigate patients’ expectative pain of spinal anesthesia puncture and anxiety pre-anesthesia, and to examine the effect of lidocaine-prilocaine cream and remimazolam prior to spinal anesthesia puncture on pain relief and anxiety release.<br/><strong>Methods:</strong> Patients undergoing spinal anesthesia were divided into control, lidocaine-prilocaine cream, and lidocaine-prilocaine cream with remimazolam groups. A questionnaire consisting of The Amsterdam Preoperative Anxiety and Information Scale (APAIS) and patient’s concerns and Visual Analog Scale (VAS) was used to evaluate patient’s anxiety and pain. The primary outcomes were differences in VAS and anxiety scores. Patient’s spinal anesthesia-related concerns, advent events and hemodynamic index were also recorded.<br/><strong>Results:</strong> The expected spinal anesthesia puncture pain was 5.34± 0.27 and anxiety scores before spinal anesthesia was 10.88 ± 0.64. A statistically significant positive correlation of 31.3% was detected between VAS and APAIS scores (r = 0.313; P=0.003). The VAS score at the time of puncture decreased by 29.7% (3.78± 0.40, P=0.001) in lidocaine-prilocaine cream group and 29.2% (3.75± 0.39, P=0.001) in lidocaine-prilocaine cream with remimazolam group compared with the expected VAS score. Lidocaine-prilocaine cream combined with or without remimazolam reduced the percentage of moderate pain (21.4% and 31.3% vs 50.0%, P=0.0001) and increased mild pain (60.7% vs 59.4% vs 22.7%, P=0.03). Anxiety score in lidocaine-prilocaine cream group was reduced by 2.84 (8.04± 0.76 vs 10.88 ± 0.46, P=0.05) when compared with pre-anesthesia. Concerns about postoperative pain (P=0.03) and fear of the needle or intervention (P=0.000) both decreased post-anesthesia among groups.<br/><strong>Conclusion:</strong> Approximately half of the patients scheduled for spinal anesthesia experienced a moderate level of preoperative anxiety. The patient’s pain expectation from the spinal anesthesia puncture was moderate, which was higher than the actual pain. Lidocaine-prilocaine cream with or without remimazolam sedative before spinal anesthesia puncture reduced the patient’s pain and anxiety scores after surgery.<br/><br/><strong>Keywords:</strong> preoperative anxiety, APAIS, spinal anesthesia, lidocaine-prilocaine, remimazolam<br/>\",\"PeriodicalId\":11290,\"journal\":{\"name\":\"Drug Design, Development and Therapy\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":4.7000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Drug Design, Development and Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2147/dddt.s468486\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CHEMISTRY, MEDICINAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Drug Design, Development and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2147/dddt.s468486","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CHEMISTRY, MEDICINAL","Score":null,"Total":0}
引用次数: 0
摘要
目的：本研究旨在调查患者对脊髓麻醉穿刺的预期疼痛和麻醉前焦虑，并探讨脊髓麻醉穿刺前使用利多卡因-阿鲁卡因乳膏和雷马唑仑对缓解疼痛和释放焦虑的影响：方法：将接受脊髓麻醉的患者分为对照组、利多卡因-阿鲁卡因乳膏组和利多卡因-阿鲁卡因乳膏加瑞马唑仑组。采用由阿姆斯特丹术前焦虑和信息量表（APAIS）、患者关注点和视觉模拟量表（VAS）组成的问卷来评估患者的焦虑和疼痛。主要结果是 VAS 和焦虑评分的差异。此外，还记录了患者与脊髓麻醉相关的担忧、突发事件和血液动力学指数：结果：预期脊髓麻醉穿刺疼痛为（5.34±0.27）分，脊髓麻醉前焦虑评分为（10.88±0.64）分。VAS评分和APAIS评分之间存在31.3%的统计学意义上的正相关（r=0.313；P=0.003）。与预期的 VAS 评分相比，利多卡因-阿鲁洛卡因乳膏组穿刺时的 VAS 评分下降了 29.7%（3.78± 0.40，P=0.001），利多卡因-阿鲁洛卡因乳膏加瑞咪唑仑组下降了 29.2%（3.75± 0.39，P=0.001）。利多卡因-普鲁卡因乳膏联合或不联合雷马唑仑可降低中度疼痛的比例（21.4% 和 31.3% vs 50.0%，P=0.0001），增加轻度疼痛的比例（60.7% vs 59.4% vs 22.7%，P=0.03）。与麻醉前相比，利多卡因-普鲁卡因乳膏组的焦虑评分降低了 2.84（8.04±0.76 vs 10.88±0.46，P=0.05）。对术后疼痛的担忧（P=0.03）和对针头或干预的恐惧（P=0.000）在麻醉后各组间均有所下降：结论：约有一半计划接受脊髓麻醉的患者在术前有中度焦虑。患者对脊髓麻醉穿刺疼痛的预期为中度，高于实际疼痛。在脊髓麻醉穿刺前使用利多卡因-阿鲁洛卡因乳膏或不使用雷马唑仑镇静剂可降低患者术后的疼痛和焦虑评分。 关键词：术前焦虑；APAIS；脊髓麻醉；利多卡因-阿鲁洛卡因；雷马唑仑
The Effect of Lidocaine-Prilocaine Cream Combined with or Without Remimazolam on VAS and APAIS Anxiety Score in Patient Undergoing Spinal Anesthesia
Purpose: This study aimed to investigate patients’ expectative pain of spinal anesthesia puncture and anxiety pre-anesthesia, and to examine the effect of lidocaine-prilocaine cream and remimazolam prior to spinal anesthesia puncture on pain relief and anxiety release. Methods: Patients undergoing spinal anesthesia were divided into control, lidocaine-prilocaine cream, and lidocaine-prilocaine cream with remimazolam groups. A questionnaire consisting of The Amsterdam Preoperative Anxiety and Information Scale (APAIS) and patient’s concerns and Visual Analog Scale (VAS) was used to evaluate patient’s anxiety and pain. The primary outcomes were differences in VAS and anxiety scores. Patient’s spinal anesthesia-related concerns, advent events and hemodynamic index were also recorded. Results: The expected spinal anesthesia puncture pain was 5.34± 0.27 and anxiety scores before spinal anesthesia was 10.88 ± 0.64. A statistically significant positive correlation of 31.3% was detected between VAS and APAIS scores (r = 0.313; P=0.003). The VAS score at the time of puncture decreased by 29.7% (3.78± 0.40, P=0.001) in lidocaine-prilocaine cream group and 29.2% (3.75± 0.39, P=0.001) in lidocaine-prilocaine cream with remimazolam group compared with the expected VAS score. Lidocaine-prilocaine cream combined with or without remimazolam reduced the percentage of moderate pain (21.4% and 31.3% vs 50.0%, P=0.0001) and increased mild pain (60.7% vs 59.4% vs 22.7%, P=0.03). Anxiety score in lidocaine-prilocaine cream group was reduced by 2.84 (8.04± 0.76 vs 10.88 ± 0.46, P=0.05) when compared with pre-anesthesia. Concerns about postoperative pain (P=0.03) and fear of the needle or intervention (P=0.000) both decreased post-anesthesia among groups. Conclusion: Approximately half of the patients scheduled for spinal anesthesia experienced a moderate level of preoperative anxiety. The patient’s pain expectation from the spinal anesthesia puncture was moderate, which was higher than the actual pain. Lidocaine-prilocaine cream with or without remimazolam sedative before spinal anesthesia puncture reduced the patient’s pain and anxiety scores after surgery.
期刊介绍：
Drug Design, Development and Therapy is an international, peer-reviewed, open access journal that spans the spectrum of drug design, discovery and development through to clinical applications.
The journal is characterized by the rapid reporting of high-quality original research, reviews, expert opinions, commentary and clinical studies in all therapeutic areas.
Specific topics covered by the journal include:
Drug target identification and validation
Phenotypic screening and target deconvolution
Biochemical analyses of drug targets and their pathways
New methods or relevant applications in molecular/drug design and computer-aided drug discovery*
Design, synthesis, and biological evaluation of novel biologically active compounds (including diagnostics or chemical probes)
Structural or molecular biological studies elucidating molecular recognition processes
Fragment-based drug discovery
Pharmaceutical/red biotechnology
Isolation, structural characterization, (bio)synthesis, bioengineering and pharmacological evaluation of natural products**
Distribution, pharmacokinetics and metabolic transformations of drugs or biologically active compounds in drug development
Drug delivery and formulation (design and characterization of dosage forms, release mechanisms and in vivo testing)
Preclinical development studies
Translational animal models
Mechanisms of action and signalling pathways
Toxicology
Gene therapy, cell therapy and immunotherapy
Personalized medicine and pharmacogenomics
Clinical drug evaluation
Patient safety and sustained use of medicines.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
