Brazilian Journal of Anesthesiology
https://app.periodikos.com.br/journal/rba/article/doi/10.1590/S0034-70942007000200003
Brazilian Journal of Anesthesiology
Scientific Article

Ansiedade no período pré-operatório de cirurgias de mama: estudo comparativo entre pacientes com suspeita de câncer e a serem submetidas a procedimentos cirúrgicos estéticos

Preoperative anxiety in surgeries of the breast: a comparative study between patients with suspected breast cancer and that undergoing cosmetic surgery

Maria Luiza Melo Alves; Adriana Jucá Pimentel; Álvaro Antônio Guaratini; José Álvaro Marques Marcolino; Judymara Lauzi Gozzani; Ligia Andrade da Silva Telles Mathias

Downloads: 0
Views: 965

Resumo

JUSTIFICATIVA E OBJETIVOS: A avaliação da ansiedade não faz parte da rotina da avaliação pré-anestésica (APA), o que faz com que situações especiais em que o estado emocional dos pacientes possa estar alterado, passem despercebidas pelo anestesiologista. Este estudo visou comparar, no momento da APA ambulatorial, fatores de risco, intensidade e prevalência de ansiedade em pacientes com suspeita de câncer de mama e a serem submetidas a procedimentos cirúrgicos estéticos de mama. MÉTODO: Após aprovação pelo Comitê de Ética, foram estudadas, no ambulatório de APA, 114 pacientes, ASA I ou II, idade > 14 anos, divididas nos grupos: GMAMA - pacientes com suspeita de câncer de mama; GPLAST - pacientes a serem submetidas à cirurgia plástica estética. Após consentimento esclarecido, as pacientes responderam o teste de avaliação de ansiedade (IDATE - Inventário de Ansiedade Traço-Estado) antes da avaliação pré-anestésica. Foram analisados: dados sociodemográficos; experiência com procedimentos cirúrgicos anteriores; número e percentual de pacientes com ansiedade baixa, moderada e alta (IDATE I e II); mediana das pontuações das escalas IDATE I e II. RESULTADOS: Os grupos foram homogêneos em relação aos dados sociodemográficos e experiência com procedimentos cirúrgicos anteriores. Observou-se diferença significativa dos níveis e prevalência de ansiedade-estado (IDATE I). Não foram identificados fatores de risco para ansiedade-estado e ansiedade-traço. CONCLUSÕES: As pacientes com suspeita de câncer de mama a serem submetidas à retirada de nódulo ou tecido mamário para diagnóstico apresentaram níveis e prevalência de ansiedade-estado alta maiores do que as pacientes a serem submetidas a mamoplastias; os níveis e a prevalência de ansiedade-traço foram similares nos dois grupos e não foram identificados fatores de risco para ansiedade-estado e ansiedade-traço.

Palavras-chave

AVALIAÇÃO PRÉ-ANESTÉSICA, CIRURGIA, Ginecológica, Plástica

Abstract

BACKGROUND AND OBJECTIVES: Evaluation of anxiety is not part of the routine pre-anesthetic evaluation (APA). Therefore, special situations in which patients might present altered mood will go unnoticed by the anesthesiologist. The objective of this study was to compare, at the moment of the outpatient basis APA, the risk factors, severity, and prevalence of anxiety in patients with suspected breast cancer and those undergoing cosmetic surgery of the breast. METHODS: After approval by the Ethics Committee, 114 patients, ASA I or II, 14 years or older, were studied at the APA clinic; they were divided in two groups: GMAMA - patients with suspected breast cancer; GPLAST - patients undergoing cosmetic surgery. After signing the informed consent, patients answered the anxiety evaluation test (STAI - State-Trait Anxiety Inventory) before the preanesthetic evaluation. The following parameters were analyzed: socio-demographic data; prior experience with surgical procedures; number and percentage of patients with low, moderate, or high anxiety (STAI I and II); and median of the STAI I and II scores. RESULTS: Both groups were homogenous regarding the socio-demographic data and prior experience with surgical procedures. There was a significant difference in the levels and prevalence of anxiety-state (STAI I). No risk factors for anxiety-state and anxiety-trait were identified. CONCLUSIONS: Patients with suspected breast cancer scheduled for nodulectomy or removal of breast tissue for diagnosis, had higher levels and prevalence of anxiety-state than patients undergoing mammaplasty; the levels and prevalence of anxiety-trait were similar in both groups; no risk factors for anxiety-state and anxiety-trait were identified.

Keywords

PREANESTHETIC EVALUATION, SURGERY, Gynecologic, Plastic

References

Ramsay MA. A survey of pre-operative fear. Anaesthesia. 1972;27:396-402.

Maranets I, Kain ZN. Preoperative anxiety and intraoperative anesthetic requirements. Anesth Analg. 1999;89:1346-1351.

Roizen MF, Foos JF, Fischer SP. Preoperative Evaluation. . .

Kraft M. Holistic issues in the preoperative period. Int Anesthesiol Clin. 2002;40:201-212.

Mackenzie JW. Daycase anaesthesia and anxiety: A study of anxiety profiles amongst patients attending a day bed unit. Anaesthesia. 1989;44:437-440.

Caumo W, Schmidt AP, Schneider CN. Risk factors for preoperative anxiety in adults. Acta Anaesthesiol Scand. 2001;45:298-307.

Magalhães Filho LL, Segurado A, Marcolino AM. Impacto da avaliação pré-anestésica sobre a ansiedade e depressão dos pacientes cirúrgicos com câncer. Rev Bras Anestesiol. 2006;56:126-136.

Schag CA, Heinrich RL. Anxiety in medical situations: adult cancer patients. J Clin Psychol. 1989;45:20-27.

Razavi D, Stiefel F. Common psychiatric disorders in cancer patients. I: Adjustment disorders and depressive disorders. Support Care Cancer. 1994;2:223-232.

Breitbart W. Identifying patients at risk for, and treatment of major psychiatric complications of cancer. Support Care Cancer. 1995;3:45-60.

Ballone GJ. Ansiedade no paciente com câncer. .

Carroll BT, Kathol RG, Noyes RJ. Screening for depression and anxiety in cancer patients using the hospital anxiety and depression scale. Gen Hosp Psychiatry. 1993;15:69-74.

DeVita V. Cancer Principles and Practice of Oncology. 2001.

Greene FL, Page DL, Fleming ID. AJCC Cancer Staging Manual. 2002.

Honigman RJ, Phillips KA, Castle DJ. A review of psychosocial outcomes for patients seeking cosmetic surgery. Plast Reconstr Surg. 2004;113:1229-1237.

Assad A, Verçosa N. Preparo Pré-Operatório. Anestesia para Cirurgia Plástica: SAERJ. 2005:13-25.

Spielberger CD. Manual for the State-Trait Anxiety Inventory (STAI: Form Y). 1983.

Biaggio AMB, Natalício L. Tradução e Adaptação do Manual de Psicologia Aplicada IDATE Rio de Janeiro. 1979.

Millar K, Jelicic M, Bonke B. Assessment of preoperative anxiety: comparison of measures in patients awaiting surgery for breast cancer. Br J Anaesth. 1995;74:180-183.

Granot M, Ferber SG. The roles of pain catastrophizing and anxiety in the prediction of postoperative pain intensity: a prospective study. Clin J Pain. 2005;21:439-445.

Noto Y, Sato T, Kudo M. The relationship between salivary biomarkers and state-trait anxiety inventory score under mental arithmetic stress: a pilot study. Anesth Analg. 2005;101:1873-1876.

Johnston M. Anxiety in surgical patients. Psychol Med. 1980;10:145-52.

Kain ZN, Mayes LC, Cicchetti DV. The Yale Preoperative Anxiety Scale: How does it compare with a "gold standard". Anesth Analg. 1997;85:783-788.

Macuco MV, Macuco OC, Bedin A. Efeito de um consultório de anestesiologia sobre as preocupações, percepções e preferências relacionadas à anestesia. Comparação entre o sexo masculino e feminino. Rev Bras Anestesiol. 1999;49:179-189.

Bottomley A. Psychosocial problems in cancer care: a brief review of common problems. J Psych Mental Health Nurs. 1997;4:323-331.

Braz DS, Ribas MM, Dedivitis RA. Quality of life and depression in patients undergoing total and partial laryngectomy. Clinics (São Paulo). 2005;60:135-142.

Mathias LAST, Guaratini AA. Avaliação Pré-Anestésica. . .

Spielberger CD. Manual for the State-Trait Anxiety Inventory for Children. 1973.

Holm L, Fitzmaurice L. Factors influencing parent anxiety levels in a pediatric emergency department waiting area. Pediatr Res. 2004;56:672.

Moro ET, Módolo NSP. Ansiedade, a criança e os pais. Rev Bras Anestesiol. 2004;54:728-738.

Astin F, Jones K, Thompson DR. Prevalence and patterns of anxiety and depression in patients undergoing elective percutaneous transluminal coronary angioplasty. Heart Lung. 2005;34:393-401.

Hsu YW, Somma J, Hung YC. Predicting postoperative pain by preoperative pressure pain assessment. Anesthesiology. 2005;103:613-618.

Padmanabhan R, Hildreth AJ, Laws D. A prospective, randomised, controlled study examining binaural beat audio and pre-operative anxiety in patients undergoing general anaesthesia for day case surgery. Anaesthesia. 2005;60:874-877.

Schupp CJ, Berbaum K, Berbaum M. Pain and anxiety during interventional radiologic procedures: effect of patients' state anxiety at baseline and modulation by nonpharmacologic analgesia adjuncts. J Vasc Interv Radiol. 2005;16:1585-1592.

Van den Bosch JE, Moons KG, Bonsel GJ. Does measurement of preoperative anxiety have added value for predicting postoperative nausea and vomiting?. Anesth Analg. 2005;100:1525-1532.

Wang S-M, Gaal D, Maranets I. Acupressure and preoperative parental anxiety: a pilot study. Anesth Analg. 2005;101:666-669.

Pan PH, Coghill R, Houle TT. Multifactorial preoperative predictors for postcesarean section pain and analgesic requirement. Anesthesiology. 2006;104:417-425.

Iwamitsu Y, Shimoda K, Abe HT. Differences in emotional distress between breast tumor patients with emotional inhibition and those with emotional expression. Psychiatry Clin Neurosci. 2003;57:289-94.

Nardi AE. Comentários do debatedor: escalas de avaliação de ansiedade. Rev Psiq Clin. 1998;25:331-333.

Morris T, Greer HS, White P. Psychological and social adjustment to mastectomy: a two year follow-up study. Cancer. 1977;40(^s2381-2387).

Maguire GP, Julier DL, Hawton KE. Psychiatric morbidity and referral on two general medical wards. Br Med J. 1978;1:268-270.

Yumi I, Kazutaka S, Hajime A. The relation between negative emotional suppression and emotional distress in breast cancer diagnosis and treatment. Health Commun. 2005;18:201-215.

Smith I, White PF, Nathanson M. Anesthesiology. 1994;81:1005-1043.

Dean C. Psychiatric morbidity following mastectomy: preoperative predictors and types of illness. J Psychosom Res. 1987;31:385-392.

Palapattu GS, Haisfield-Wolfe ME, Walker JM. Assessment of perioperative psychological distress in patients undergoing radical cystectomy for bladder cancer. J Urol. 2004;172:1814-1817.

Smith AB, Selby PJ, Velikova G. Factor analysis of the Hospital Anxiety and Depression scale from a large cancer population. Psychol Psychother. 2002;75:165-176.

Burgess C, Cornelius V, Love S. Depression and anxiety in women with early breast cancer: five year observational cohort study. BMJ. 2005;330:702-710.

Sarna L, Brown JK, Cooley ME. Quality of life and meaning of illness of women with lung cancer. Oncol Nurs Forum. 2005;32:9-19.

5dd83fac0e8825665e13f288 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections