CAJ | 학술논문

目的：探讨初次全膝关节置换术（ TKA）患者术前焦虑状态对术后镇痛效果及麻醉恢复情况的影响。方法纳入长征医院骨科2012年9月至2013年9月间84例行TKA手术的住院患者进行前瞻性队列研究，通过术前贝克焦虑量表（ BAI ）将患者分为高焦虑组（ A组）和低焦虑组（ B组）。对比两组的一般资料、手术时间、麻醉时间、拔管时间及麻醉后副反应，分别于术后1、2、4、8、12、24 h进行视觉模拟量表（ VAS）评分并记录12、24 h的曲马多用量。结果共有38（45．24％）的患者术前处于高焦虑状态，两组间的一般资料、手术及麻醉时间没有统计学差异，但B组拔管时间、麻醉后副反应少于A组，术后2、4、8、12 h的VAS评分低于A组，术后曲马多用量少于A组，结果有统计学意义（ P＜0．05）。结论 TKA患者术后疼痛程度与术前焦虑情绪有关。高焦虑状态会影响麻醉恢复及镇痛效果，增加药物用量。
목적：탐토초차전슬관절치환술（ TKA）환자술전초필상태대술후진통효과급마취회복정황적영향。방법납입장정의원골과2012년9월지2013년9월간84례행TKA수술적주원환자진행전첨성대렬연구，통과술전패극초필량표（ BAI ）장환자분위고초필조（ A조）화저초필조（ B조）。대비량조적일반자료、수술시간、마취시간、발관시간급마취후부반응，분별우술후1、2、4、8、12、24 h진행시각모의량표（ VAS）평분병기록12、24 h적곡마다용량。결과공유38（45．24％）적환자술전처우고초필상태，량조간적일반자료、수술급마취시간몰유통계학차이，단B조발관시간、마취후부반응소우A조，술후2、4、8、12 h적VAS평분저우A조，술후곡마다용량소우A조，결과유통계학의의（ P＜0．05）。결론 TKA환자술후동통정도여술전초필정서유관。고초필상태회영향마취회복급진통효과，증가약물용량。
Objective To evaluate the impacts of preoperative anxiety on postoperative pain and recovery from anesthesia in the patients undergoing total knee arthroplasty (TKA).Methods A total of 84 patients with osteoarthritis who underwent unilateral TKA between September 2012 and September 2013 were separated into two groups according to Beck′s anxiety inventory ( BAI):the patients with anxiety were enrolled in the high-anxious patient group (group A) and the patients without anxiety were enrolled in the low-anxious group ( group B ) .During the perioperative period , all the patients received patient-controlled analgesia (PCA) for 24h postoperatively.General information, duration of surgery, duration of anesthesia, extubation time, adverse effects, drug dosage for 12 and 24h, and Visual analog score ( VAS) were assessed and compared between the two groups .Results Among all the patients, 38 patients (45.24%) had preoperative anxiety according to the preoperative score of BAI .There was no significant difference in the general information , the duration of surgery and anesthesia between the two groups .The extubation time was significantly longer and more postoperative side effects were determined in group A than in group B .In group A, the postoperative VAS scores at 2, 4, 8, 12h and tramadol consumption were significantly higher ( P<0.05 ) .Conclusion The results of this study suggest that high preoperative anxiety level does negatively influence the experience of postoperative pain and recovery from anesthesia , it also increases the need for postoperative analgesia .