Preoperative Anxiety and Postoperative Pain in Patients With Laparoscopic Hysterectomy.

Objective: This study was designed to investigate preoperative anxiety situations and postoperative pain degree in Chinese patients undergoing laparoscopic hysterectomy and to analyze the related factors of preoperative anxiety and the correlation between preoperative anxiety and postoperative pain to provide a reference for effective postoperative analgesia management. Methods: A total of 100 female patients undergoing laparoscopic hysterectomy were enrolled in this study and randomly divided into two groups (n = 50, each). In group A, the patients were treated with dexmedetomidine and sufentanil for postoperative analgesia. In group B, the patients were treated with sufentanil alone for postoperative analgesia. All patients were evaluated with a self-rating anxiety scale (SAS) 1 day before the operation. The patients' pain was evaluated using the numerical rating scale (NRS) 1 day after the operation, and data were recorded. Results: In these 100 patients, the highest preoperative SAS score was 48, and the average score was 40.99 ± 4.55 points, which is higher than the norm in China. There were significant differences in preoperative SAS scores among patients with different occupations and previous surgical experience (P < 0.05). There was no significant difference in SAS scores among patients with different education levels (P > 0.05). The postoperative NRS score of group A was significantly higher than that of group B, and the difference was statistically significant (P < 0.05). The correlation coefficients between SAS scores and NRS scores in groups A and B were 0.836 and 0.870, respectively, presenting with a significantly positive correlation. Conclusion: Preoperative anxiety is an important predictor of postoperative pain. Patients undergoing laparoscopic hysterectomy have preoperative anxiety. The degree of anxiety is influenced by the occupation and previous operation experience of the patients, and patients with higher preoperative anxiety have greater postoperative pain. In addition, we should not neglect the management of postoperative pain because of the small trauma of laparoscopic surgery, and dexmedetomidine combined with sufentanil can improve the postoperative analgesic effect.

[Influence factors of post-traumatic stress disorder (PTSD) and depression symptoms in children and adolescents after Wenchuan earthquake in China].

OBJECTIVE: This study was to analyze the mental health status of the children and adolescents from the areas struck by Wenchuan earthquake and to understand the factors that may have impact on their mental health after exposing to the earthquake. METHODS: Subjects of this survey were students (8 - 16 years old) from Chendu, Dujiangyan, Beichuan and Wenchuan districts which were the most severely affected areas in the earthquake. We analyzed the subjects' mental health conditions after Wenchuan earthquake by using a general questionnaire that was composed of the Children's Revised Impact of Event Scale (CRIES-13) and Depression Self-rating Scale for Children (DSRSC). Students are investigated 7341 case, 7387 case, 7395 case after 3, 6, 24 months. The data were analyzed with logistic regression model. RESULTS: The CRIES-13 scores were (27.51 ± 12.26), (23.54 ± 12.79) and (21.35 ± 12.59) (F = 28.842, P ≤ 0.05) and the DSRSC scores were (11.79 ± 5.73), (10.94 ± 5.50) and (10.75 ± 5.27) (F = 17.084, P ≤ 0.05) 3, 6 and 24 months after the earthquake, respectively. The risk factors associated with depression 3, 6, 24 months after the earthquake were gender (female) (OR values were 2.14, 2.72, 2.31; 95%CI values were 1.01 - 3.03, 1.10 - 5.01, 1.02 - 4.58), age (less than 12 years old) (OR values were 1.97, 2.22, 1.93; 95%CI values were 1.43 - 3.17, 1.02 - 3.54, 1.32 - 3.27), having family member injury and death (OR values were 2.19, 2.45, 2.35; 95%CI values were 1.04-2.89, 1.16-2.08, 1.02 - 2.79), desperation (OR values were 2.24, 2.09, 2.16; 95%CI values were 1.00 - 2.54, 1.70 - 2.58, 1.00 - 4.56). The risk factors associated with PTSD 3, 6, 24 months after the earthquake were gender (OR values were 2.16, 2.94, 1.96; 95%CI values were 1.36 - 2.53, 1.36 - 2.53, 1.06 - 3.92), age (less than 12 years old) (OR values were 3.51, 2.62, 1.92; 95%CI values were 1.22 - 5.40, 1.14 - 4.93, 1.08 - 3.35), having teachers and schoolmates injury and death (OR values were 2.32, 2.48, 2.36; 95%CI values were 1.17 - 2.48, 1.30 - 2.72, 1.02 - 2.85), having family member injury and death (OR values were 2.73, 2.21, 1.85;95%CI values were 1.67 - 3.61, 1.04 - 3.15, 1.05 - 2.38), witnessing injury (OR values were 2.17, 2.36, 2.34; 95%CI values were 1.15 - 3.65, 1.17 - 2.67, 1.02 - 3.67), witnessing death (OR values were 1.98, 2.39, 1.71;95%CI values were 1.10 - 2.56, 1.14 - 3.70, 1.57 - 3.88), desperation (OR values were 2.02, 1.94, 2.02; 95%CI values were 1.67 - 2.35, 1.66 - 2.27, 1.82 - 2.26). CONCLUSION: The symptoms of PTSD and depression of young survivors from the earthquake-struck areas had gradually alleviated 3, 6, 24 months after the earthquake. Age (less than 12 years old), gender (female), having family member injury and death, witnessing injury and death, and desperation were the main risk factors that affected the children and adolescents mental health.

[The mental health of children and adolescents from earthquake affected areas].

OBJECTIVE: To examine the mental health status of 11-16 years old children exposed to the 5.12 WenChuan earthquake and to help develop post-traumatic psychological interventions. METHODS: The self-reported Strengths and Difficulties Questionnaire (SDQ) was administered to 540 children (mean age: 13.82+/-0.98, male/female ratio 1.06:1) from the earthquake affected areas one month after the earthquake. RESULTS: (1) The children had an average difficulty score (T score) of 13.41+/-5.71, with 74.6% reporting at least minor perceived difficulties. (2) The children with higher levels of exposure had higher emotional subscale scores (z=-2.323, P=0.020). The female students had higher emotional subscale scores than the male students (z=-4.985, P=0.000). (4) The impact of the difficulties on the children's learning increased with age (z=9.106, P=0.011). (5) The longer the children lived in the transferred safe places, the more likely the children got an abnormal (OR=1.233, P=0.003). CONCLUSION: The mental health status of the children from the earthquake affected areas are influenced by their exposure levels, gender, age and the length of living in transferred safe places. These factors should be taken into considerations when post-traumatic psychological interventions are planned.