Can Verbal Interview Decrease Preoperative Anxiety and Postoperative Discomfort in Oral and Maxillofacial Surgery Patients?: A Randomized Clinical Trial.

BACKGROUND: Preoperative anxiety is a condition that can be seen frequently in oral and maxillofacial surgery patients and affects the recovery process. PURPOSE: The aim of this study was to determine the effect of preoperative educational or informative interviews on preoperative anxiety levels and postoperative discomfort in patients undergoing oral and maxillofacial surgery. STUDY DESIGN, SETTING, AND SAMPLE: This prospective randomized clinical trial involved patients who underwent oral and maxillofacial surgery at Aydin-Adnan-Menderes University, Oral and Maxillofacial Surgery Hospital. Patients with neurological or psychological disorders, a history of previous psychiatric drug use, those who used anxiolytic or sedative drugs before surgery, those who required postoperative anxiolytic and opioid administration, or patients who underwent nonstandard surgical and anesthesia protocols were excluded. EXPOSURE VARIABLE: Preoperative educational or informative interview is the exposure variable. Subjects were randomly assigned to the intervention and control groups. MAIN OUTCOME VARIABLES: The primary outcome variable was preoperative anxiety measured by the Spielberger State-Trait Anxiety Inventory and the Amsterdam Preoperative Anxiety and Information scale (APAIS). The secondary outcome variables were postoperative pain measured by visual analog scale at the first and sixth hours, postoperative nausea (repeated gagging or spitting), and postoperative vomiting (active vomiting) were observed within 6 hours following general anaesthesia. COVARIATES: The study's covariates were age, weight, sex, American Society of Anesthesiologists Physical Status Classification System score, marital status, edicational background, surgery procedure, anesthesia procedure, duration of surgery, and recovery time. ANALYSES: The χ2 and student t-tests were used to compare primary predictor and covariates against outcome variables. A P value <.05 was considered significant. RESULTS: A total of 92 patients were included in this study, with 46 randomized to intervention group and 46 to control group. The mean age (37.78 ± 13.94 years vs 33.34 ± 15.17 years, P = .16) and sex differences (female/male: 16/30(34.8/65.2) versus 26/20(56.5/43.5), P = .06) were comparable between groups. While higher values were recorded in the average anxiety scores in the control group than in the study group, statistically significant differences were found [Spielberger State-Trait Anxiety Inventory-S (37.36 ± 10.87 vs 52.39 ± 12.13) (P < .01), APAIS-T (15.82 ± 5.35 vs 21.39 ± 6.69) (P < .01), APAIS-A (4.17 ± 2.12 vs 6.47 ± 2.15) (P < .01), APAIS-B (5.76 ± 2.03 vs 7.65 ± 2.60) (P < .01), and APAIS-C (6.04 ± 2.47 vs 7.21 ± 2.38), (P < .05)]. At the same time, there was also a significant difference in terms of early postoperative pain [(2.08 ± 2.77 vs 3.43 ± 2.86), (P = .02)] and postoperative nausea [12/34 (26.1/73.9) versus 25/21(54.3/45.7), (P = .01)]. CONCLUSIONS AND RELEVANCE: Oral and maxillofacial surgery causes significant situational anxiety. This study showed that preoperative educational or informative interviews reduced preoperative anxiety levels and postoperative discomfort, such as early postoperative pain, nausea, and vomiting.

Comparison of some biochemical properties of artichoke polyphenol oxidase entrapped in alginate-carrageenan and alginate gels.

Polyphenol oxidase (PPO, EC.1.14.18.1) isolated from artichoke (Cynara scolymus) was entrapped within alginate and alginate+ carrageenan beads, and the catecholase and cresolase activities of both entrapped enzymes were determined. Some properties of these immobilized enzymes such as optimum pH and temperature, kinetic parameters (Km and Vmax), thermal, and storage stability were determined and compared to each other. The highest catecholase activity was observed in alginate gel (370 U/g bead) while the highest cresolase activity was in alginate+ carrageenan gel (90 U/g bead). For catecholase and cresolase activities, optimum pHs of alginate and alginate+ carrageenan beads were determined to be 7.0 and 4.0, respectively. Optimum temperatures for catecholase activity were determined to be 40°C for both entrapped enzymes. These values for cresolase activity were 30°C and 20°C, respectively. Immobilized artichoke PPOs greatly preserved their thermal stability which exists anyway. The catalytic efficiency value (Vmax/Km) of the alginate beads is approximately high as two-and-a-half folds of that of alginate+κ-carrageenan beads for cresolase activity. These values were very close for catecholase activity. Immobilized beads saved their both activities after 30 days of storage at 4°C.

Optimization of polyphenol oxidase immobilization in copper alginate beads.

Polyphenol oxidase (PPO, EC 1.14.18.1) was isolated from artichoke head (Cynara scolymus L.) by using 0.1 M Tris-HCl buffer (pH 7.0), concentrated by (NH4)2SO4 precipitation, and immobilized in copper-alginate beads. Immobilization yield was determined to be 70%. The cresolase and catecholase activities of enzyme immobilized at optimum immobilization conditions were found to be 13.3 and 670 U g beads min(-1), respectively. Effects of immobilization conditions such as alginate concentration, CaCl2 concentration, amount of loading enzyme, bead size, and amount of beads on enzymatic activity were investigated. Optimum alginate and CuCl2 concentration were found to be 2 % and 3 % (w/v), respectively. Using bead (diameter 3 mm) amount of 0.25 g maximum enzyme activities were observed for both polyphenol activities. The initial concentrations of loading free enzyme were 6.5 U mL(-1) and 5815 U mL(-1) for cresolase activity and catecholase activities, respectively. Beads prepared at optimum immobilization conditions were suitable for up to 8 repeated uses.