Assessment Of Perioperative Mental Status Of Burn Patients And Analysis Of Influencing Factors

Objective:Various scales were applied to systematically assess the perioperative mental status,intraoperative conditions and postoperative outcome of burn patients,and to explore the relevant influencing factors of improving the mental status of burn patients in order to promote their early recovery.Methods:One hundred and ten burn patients undergoing elective surgery under general anesthesia were included in the Fourth Medical Center of the PLA General Hospital from February 2022 to August 2022.All patients were measured with Self-Rating Anxiety Scale（SAS）,Visual Analogue Scale-pain（VAS-p）,Visual Analogue Scale-anxiety（VAS）,Mini-Mental State Examination（MMSE）before and 1-day post operation.The patients’parameters including heart rate（HR）,mean arterial pressure（MAP）were recorded at admission（T₀）,before induction of anesthesia（T₁）,2 min after intubation（T₂）,15 min from the start of surgery（T₃）,during surgery（T₄）,before the end of surgery（T₅）,leaving the operating room（T₆）.Results:The incidence of preoperative anxiety and postoperative anxiety in burn patients was 29.1%and 22.3%respectively.Univariate logistic analysis showed that the related factors of preoperative anxiety were female（P=0.002）,initial diagnosis of burn injury（P=0.046）,head and neck burns（P=0.035）,burn area between 10%and 30%（P=0.005）and preoperative pain（P=0.001）.The related factors of postoperative anxiety were preoperative anxiety status（P=0.000）,initial diagnosis of burn injury（P=0.030）,head and neck burns（P=0.016）,burn area between 10%and 30%（P=0.001）and postoperative pain（P=0.021）.Multivariate logistic regression analysis revealed that gender,preoperative pain and preoperative anxiety status were the independent influencing factors（P<0.05）.Compared to patients without anxiety states（SAS<50）,there were no significant difference in perioperative MAP（P>0.05）of anxious patients,but perioperative HR was faster（P<0.05）;and the operating time,anesthesia time,and intraoperative sufentanil,remifentanil,and propofol use were significantly higher in patients with anxiety status（P<0.05）.Conclusion:The anxiety state of burn patients before operation was significantly higher than that after operation.In perioperative management,there was no significant difference in mean arterial pressure among anxious patients,but their heart rate was significantly faster.The gender and post-burn pain are independent factors for the preoperative anxiety state,while the independent influencing factor for the postoperative anxiety status is only whether the preoperative patient has an anxiety state.In addition,patient age,blood type,occupation,BMI,preoperative comorbidities,number of surgeries,hospitalization days and operation type were not significantly associated with the perioperative anxiety status of burn patients.Optimizing perioperative management for the anxiety risk factors of burn patients,it is expected to improve the mental state of burn patients,in order to promote the wound recovery and rapid rehabilitation of patients,and improve the long-term quality of life of patients.