Investigation And Analyzation Of Preoperative Anxiety State Of Dermatologic Day-case Surgery Patients

Background: Surgery is a stressor for patients,who are mainly encountered the preoperative anxiety when waiting for the surgery.Many studies have indicated that,when the patients were in the state of anxiety,there was lower degree of patients` satisfaction.Preoperative anxiety may cause many physical and mental changes and complications that affect the success of surgery,such as effects on cognitive abilities,physical and mental discomfort,increased complications such as changes in threshold of pain,vasovagal syncope.State-anxiety inventory(S-AI)is the most common measure of anxiety among patients scheduled for day-case surgery.The stress system mainly include sympathetic-adrenal medulla system(SAMS)and hypothalamic-pituitary-adrenocortical axis(HPAS).The epinephrine(E)and norepinephrine(NE),secreted much more when SAMS activated,are the indicators of stress and also the important plasma indicators for surgical stress study.The dermatologic surgery has been developed rapidly in recent decades.The aim of the dermatologic surgery is not only to deal with skin diseases,but also to meet the need of patients for beauty.So,that is the point where dermatologic surgery differs from other surgeries.There are a few of studies,which are mostly focus on some special surgeries such as Mohs and nail surgery,on dermatlogic surgical stress,but few studies on general dermatologic surgeries.So,our study concentrated on this point.Part one: Investigation of preoperative anxiety state of dermatologic day-case surgery patientsObjective: To investigate the preoperative anxiety level and influence factors of dermatologic surgery patients for guiding clinical works.Method: This study consists of two sections : at the first one,we used a descriptive study to investigate the preoperative anxiety level of 193 dermatologic surgery patients in a single center.Stepwise regression analysis was selected for determining the influence factors of the preoperative anxiety level.The data were analyzed by T-test,ANOVA,analysis of covariance and regression when needed.Results: The investigating data showed that gender,age,degree of education and operative site were the influence factors.While,marital status,way of paying,home address,occupation and diagnosis are not.1 The female patients average S-AI score(41.62±6.17)was statistically higher than that in the norm(39.00±8.40)(P<0.05),but the male patients average S-AI score(35.15 ± 5.56)was statistically lower than that in the norm(39.71 ± 8.89)(P<0.05).The female patients average S-AI score was statistically higher than that in the male patients.It suggests that the female of dermatologic surgery have high level of psychological stress.2 There were statistically difference among the age groups.The >60 age group had the lowest score and the 26-40 age group had the highest score.3 There were statistically difference among the degree of education groups.The higher degree of education had the lower S-AI score.Bachelor degree and above group was statistically lower than that in other groups.4 The operative site had statistically difference.Facial site and female mamma site group had the highest score than that in the others.5 Stepwise regression analysis found that the influence factors of preoperative anxiety were gender(t=6.672),operative site(t=-2.229)and degree of education(t=-2.143).Part two: Investigation of the concentrations of the plasma E and NE in preoperative anxiety state of dermatologic day-case surgery patientsObjective: To explore the relationship between the concentrations of the plasma E and NE and preoperative anxiety in dermatologic patients.Method: 30 patients undergoing dermatologic surgery were enrolled in our study.The first step,we investigated the preoperative anxiety level of the30 patients,then detected the concentrations of the plasma E and NE and analyzed the influence factors.The data were analyzed by T-test,ANOVA,analysis of covariance and regression when needed.Results: The female patients average S-AI score(43.58 ± 6.33)was statistically higher than that in the norm(39.00±8.40)(P<0.05),but the male patients average S-AI score(34.00±5.29)was statistically lower than that in the norm(39.71±8.89)(P<0.05).The women patients average S-AI score was statistically higher than that in the men patients.The level of the concentrations of plasma E and NE were statistically increased than that of the control group.The regression analysis found that the operative site was an important influence factor on preoperative anxiety.Conclusions: Part of dermatologic surgery patients have some degree of preoperative anxiety,which may be influenced by gender,age,degree of education and operative site.The operative site is an important influence factor,which affects the preoperative anxiety level and the concentrations of the plasma E and NE,about dermatologic day-case surgery patients.