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PREOPERATIVE ANXIETY AND PAIN SENSITIVITY ARE INDEPENDENT PREDICTORS OF PROPOFOL AND SEVOFLURANE REQUIREMENTS IN GENERAL ANAESTHESIA

NUR NADRAH BINTI MD YUSOF 030.08.310 UNIVERSITAS TRISAKTI ANAESTHESIA DEPARTMENT RSOB BATAM

ABSRACT
BACKGROUND : Psychological factors variations in anaesthetic and analgesic requirements Study can preoperative psychological factors predict anaesthetic requirements and postoperative pain?

ABSTRACT
METHODS: Total thyroidectomy; 100 women Spielbergers State-Trait Anxiety Inventory (STAI) Pain sensitivity questionnaire (PSQ) Induction of anaesthesia : Propofol Sevoflurane + oxygen + air Bispectral index (BIS)

ABSTRACT
RESULTS : Higher anxiety scores (S&T), greater amounts of propofol light and moderate level of sedation Higher trait anxiety deep level of sedation MAC-hour of sevoflurane PSQ Postoperative pain intensity STAI and PSQ

ABSTRACT
CONCLUSIONS : Preoperative anxiety and pain sensitivity are independent predictors of propofol and sevoflurane requirements in general anaesthesia Doses could be modified

BACKGROUND
Sevoflurane Propofol

Postoperative pain intensity

Increased preoperative anxiety and pain sensitivity

METHODS
100 women, ASA I, elective total thyroidectomy, informed consent, fasted 6 hours, no premedication

STAI and PSQ

OT : standard monitoring; BIS measure the depth of anaesthesia

HR, SAP, DAP, SpO, BIS

METHODS
Propofol --> target-controlled infusion system (preset target : 2.5 microgram/ml) BIS index do not reach next, deeper level in 3 minutes increased 0.5 microgram/ml

Fentanyl 1 microgram/kg, Rocuronium 0.6 mg/kg


Sevoflurane in 50% oxygen (flow rate 4 ml/min) MAC-hour was recorded

METHODS
Postoperative pain VAS (0-10); 1, 24, 48 hours after surgery, VAS 5 Fentanyl 0.5 microgram/kg

Postoperative side-effects were recorded and treated

RESULTS
S&T anxiety , propofol (light and moderate sedation)

S anxiety T anxiety

T anxiety , propofol (deep sedation)

MAC-hour of sevoflurane PSQ score

VAS 1 hour STAI and PSQ

VAS 24, 48 hours PSQ

DISCUSSION
ANXIETY : unpleasant emotional state or condition

STATE ANXIETY : subjective feelings when subjected to anxietyprovoking stimulus

TRAIT ANXIETY : individual differences in the disposition of responses to stressful situations

ANXIETY : lower pain threshold, overestimation of pain intensity, activation of entorhinal cortex of the hippocampal formation

PAIN : complex, subjective, emotional sensory experience; physiochemical and affective components