DYNAMICS OF STRESS LABORATORY FINDINGS AND THEIR RELATION TO PSYCHOEMOTIONAL STATE DURING REGIONAL ANESTHESIA IN PATIENTS WITH LOWER LIMBS INJURIES

Keywords: regional anesthesia, lower limbs injury, pain intensity, psychoemotional state, biochemical markers of stress

Abstract

The choice of an adequate method of anesthesia for surgical treatment of lower limbs injuries remains a critical task today. Each method applied in this treatment has its advantages and disadvantages. In recent years, regional anesthesia has been the preferential method.

The aim of the study. To study the stress laboratory findings and their relation to the patients’ psychoemotional state in perioperative period while performing regional and combined anesthesia.

Material and methods. It was studied 60 patients aged 18-59 years, who underwent metal osteosynthesis operations due to lower limbs injuries. Surgical treatment was performed under regional anesthesia and regional anesthesia followed by sedation. The patients of both groups were conducted heamodynamics monitoring and determined the intensity of pain in accordance with visual analogue scale and stress indicators with a laboratory method. The psychoemotional state was assessed with the Spielberger-Hanin anxiety scale.

Results. According to the study it was determined, that in patients, who were planned to have surgery, significant psychoemotional stress and stress concentration of hormones in the blood and their interrelation was discovered. Patients about before surgery had a relationship between situational anxiety and cortisol r=0.7; p=0.00006 in group I; r=0.6; p=0.002 in the second group. The relationship between VAS and cortisol r=0.5; p=0.04 in groups I and II. After surgery, the connection was in group I patients between situational anxiety and cortisol r=0.4; p=0.02; the relationship between insulin and the HOMA index r=0.5; p=0.01.

Conclusions. Before the operation, all patients revealed significant psychoemotional stress and stressful changes in the concentration of hormones in the blood. Reliably pronounced dynamics of the indicators was with the use of combined conduction anaesthesia. Thus, the performed study allows to recommend combined regional anesthesia as the method of anesthesia choice, particularly in patients with high anxiety.

Downloads

Download data is not yet available.

Author Biography

Elina Korobko, Kharkiv Medical Academy of Postgraduate Education

Department for Traumatology, Anesthesiology and Military Surgery

 

 

References

Tobin, J. M., Barras, W. P., Bree, S., Williams, N., McFarland, C., Park, C. et. al. (2018). Anesthesia for Trauma Patients. Military Medicine, 183(suppl_2), 32–35. doi: http://doi.org/10.1093/milmed/usy062

Bohuslavska, N. M., Heorhiiants, M. A. (2015). Choice of the method of anesthesia management of traumatological surgeries in young patients. ScienceRise, 7 (4 (12)), 28–35. doi: http://doi.org/10.15587/2313-8416.2015.47374

Gadsden, J., Warlick, A. (2015). Regional anesthesia for the trauma patient: improving patient outcomes. Local and Regional Anesthesia, 8, 45–55. doi: http://doi.org/10.2147/lra.s55322

Shapovalov, A. A. (2017). Klinicheskaya effektivnost sposoba blokady sedalishnogo nerva lateralnym dostupom pri metallosteosinteze perelomov kostei goleni i stopy. Saint Petersburg, 95.

Logvinenko, V V., Shen, N. P. (2015). Sravnitelnaia kharakteristika riskov razvitiia nezhelatelnykh sobytii i kriticheskikh incidentov pri obschei i regionarnoi anestezii. Analiz 6 let klinicheskoi praktiki. Regionarnaya anesteziya i lechenie ostroi boli, IX (2), 22–28.

Voysekhovskiy, D. V., Averyanov, D. A., Schegolev, A. V., Svistov, D. V. (2018). Effect of deep anesthesia on development of post-operative cognitive dysfunction. Messenger of Anesthesiology and Resuscitation, 15 (1), 5–9. doi: http://doi.org/10.21292/2078-5658-2018-15-1-5-9

Huo, T., Sun, L., Min, S., Li, W., Heng, X., Tang, L. et. al. (2016). Major complications of regional anesthesia in 11 teaching hospitals of China: a prospective survey of 106,569 cases. Journal of Clinical Anesthesia, 31, 154–161. doi: http://doi.org/10.1016/j.jclinane.2016.01.022

McIntyre, J. W. R., Finucane, B. T. (2017). Regional Anesthesia Safety. Complications of Regional Anesthesia, 15–40. doi: http://doi.org/10.1007/978-3-319-49386-2_2

Tarabrin, O. A., Suslov, V. V., Fesenko, V. S., Maruhnyak, L. I., Sherbakov, S. S. (2013). Oslozhneniya perefericheskih nevralnyh blokad. Klinichna anesteziologiya ta intensivna terapiya, 1, 106–119.

Allegri, M., Bugada, D., Grossi, P., Manassero, A., Pinciroli, R., Zadra, N. et. al. (2016). Italian registry of complications associated with regional anesthesia (RICALOR). an incidence analysis from a prospective clinical survey. Minerva Anestesiologica, 82 (4), 392–402.

Ovechkin, A. M., Politov, M. E. (2018). Problemy bezopasnosti regionarnoi anestezii na sovremenom etape. Anesteziologiya i reanimatologiya, 63 (1), 9–16.

Steadman, J., Catalani, B., Sharp, C., Cooper, L. (2017). Life-threatening perioperative anesthetic complications: major issues surrounding perioperative morbidity and mortality. Trauma Surgery & Acute Care Open, 2 (1), e000113. doi: http://doi.org/10.1136/tsaco-2017-000113

Merry, A. F., Mitchell, S. J. (2018). Complications of anaesthesia. Anaesthesia, 73, 7–11. doi: http://doi.org/10.1111/anae.14135

Bradshaw, P., Hariharan, S., Chen, D. (2016). Does preoperative psychological status of patients affect postoperative pain? A prospective study from the Caribbean. British Journal of Pain, 10 (2), 108–115. doi: http://doi.org/10.1177/2049463716635680

Pinto, A., Faiz, O., Davis, R., Almoudaris, A., Vincent, C. (2016). Surgical complications and their impact on patients’ psychosocial well-being: a systematic review and meta-analysis. BMJ Open, 6 (2), e007224. doi: http://doi.org/10.1136/bmjopen-2014-007224

Powell, R., Scott, N. W., Manyande, A., Bruce, J., Vögele, C., Byrne-Davis, L. M. et.al. (2016). Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. Cochrane Database of Systematic Reviews. doi: http://doi.org/10.1002/14651858.cd008646.pub2

Stark, P. A., Myles, P. S., Burke, J. A. (2013). Development and Psychometric Evaluation of a Postoperative Quality of Recovery Score. Anesthesiology, 118 (6), 1332–1340. doi: http://doi.org/10.1097/aln.0b013e318289b84b

Zagurovskii, V. M. (2014). Stress i ego posledstviya (dogospitalnyj i rannii gospitalnyi etapy). Medicina neotlozhnyh sostoyanii, 7 (62), 11–23.

Strashnov, V. I., Zabrodin, O. N., Mamedov. A. D. et. al. (2015). Preduprezhdenie intraoperacionnogo stressa i ego posledstvii. Saint Petersburg: ELBI-SPb, 160.

Syusyuka, V. G. (2015). Ocenka balansa kortizol/insulin u beremennyh s razlichnym urovnem trevozhnosti. Suchasni medichni tehnologiyi, 1, 65–70.

Kolomachenko, V. I., Krivobok, V. I., Fesenko, V. S. (2010). Predoperaciina ta pislyaoperaciina trivozhnist v ortopedichnih paciyentiv: korelyaciya z biohimichnimi stres-markerami. Ukrainskii visnik psihonevrologiyi, 18 (2 (63)), 52–56.


👁 165
⬇ 123
Published
2020-07-31
How to Cite
Korobko, E. (2020). DYNAMICS OF STRESS LABORATORY FINDINGS AND THEIR RELATION TO PSYCHOEMOTIONAL STATE DURING REGIONAL ANESTHESIA IN PATIENTS WITH LOWER LIMBS INJURIES. EUREKA: Health Sciences, (4), 51-57. https://doi.org/10.21303/2504-5679.2020.001365
Section
Medicine and Dentistry