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Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel-Group Study

BACKGROUND: Patients undergoing elective cardiac surgery often experience pre-operative anxiety. Preoperative anxiety influences surgical outcome. There are very few studies which have assessed the impact of clonidine and Gabapentin in the treatment of anxiety especially in Indian populations and it...

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Autores principales: Mudgalkar, Nikhil, Kandi, Venkataramana, Baviskar, Aashish, Kasturi, Ravinder Reddy, Bandurapalli, Bindusha
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9387608/
https://www.ncbi.nlm.nih.gov/pubmed/35799556
http://dx.doi.org/10.4103/aca.aca_80_21
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author Mudgalkar, Nikhil
Kandi, Venkataramana
Baviskar, Aashish
Kasturi, Ravinder Reddy
Bandurapalli, Bindusha
author_facet Mudgalkar, Nikhil
Kandi, Venkataramana
Baviskar, Aashish
Kasturi, Ravinder Reddy
Bandurapalli, Bindusha
author_sort Mudgalkar, Nikhil
collection PubMed
description BACKGROUND: Patients undergoing elective cardiac surgery often experience pre-operative anxiety. Preoperative anxiety influences surgical outcome. There are very few studies which have assessed the impact of clonidine and Gabapentin in the treatment of anxiety especially in Indian populations and its implications on major adverse cardiac events (MACE) and 30 days mortality. MATERIALS AND METHODS: Adult patients aged 18 to 80 years old who were scheduled to have an elective coronary artery by-pass graft (CABG) were included in the study. Those who satisfied the inclusion criteria were given either Gabapentin (800 mg) or Clonidine (300 mcg) 90-120 minutes before the induction. State trait anxiety inventory (STAI) was used to assess anxiety in baseline and taking just before operating room. The primary endpoint was a reduction in the STAI associated with the study drug, while the secondary endpoint was the incidence of MACE in the perioperative period (30 days), which included composite episodes of non-fatal cardiac arrest, chaotic rhythm, acute myocardial infarction, congestive heart failure, cardiac arrhythmia, angina, and death. RESULTS: A total of 75 patients were considered for the statistical analysis. The demographic and clinical features of the study participants were similar in both groups. Nearly 75-80% of participants had severe anxiety in the preoperative period while 10-20% had moderate anxiety. While both the drugs showed a reduction in the anxiety levels, the clonidine group fared better (statistically insignificant). The incidence of MACE was similar in both groups. CONCLUSION: The preoperative anxiety levels were high among cardiac surgery patients. Both clonidine and gabapentin were equally effective in reducing the levels of preoperative anxiety. Preoperative STAI scores in the range of 32-53 is not associated with MACE and 30-day mortality among cardiac surgery patients.
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spelling pubmed-93876082022-08-19 Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel-Group Study Mudgalkar, Nikhil Kandi, Venkataramana Baviskar, Aashish Kasturi, Ravinder Reddy Bandurapalli, Bindusha Ann Card Anaesth Original Article BACKGROUND: Patients undergoing elective cardiac surgery often experience pre-operative anxiety. Preoperative anxiety influences surgical outcome. There are very few studies which have assessed the impact of clonidine and Gabapentin in the treatment of anxiety especially in Indian populations and its implications on major adverse cardiac events (MACE) and 30 days mortality. MATERIALS AND METHODS: Adult patients aged 18 to 80 years old who were scheduled to have an elective coronary artery by-pass graft (CABG) were included in the study. Those who satisfied the inclusion criteria were given either Gabapentin (800 mg) or Clonidine (300 mcg) 90-120 minutes before the induction. State trait anxiety inventory (STAI) was used to assess anxiety in baseline and taking just before operating room. The primary endpoint was a reduction in the STAI associated with the study drug, while the secondary endpoint was the incidence of MACE in the perioperative period (30 days), which included composite episodes of non-fatal cardiac arrest, chaotic rhythm, acute myocardial infarction, congestive heart failure, cardiac arrhythmia, angina, and death. RESULTS: A total of 75 patients were considered for the statistical analysis. The demographic and clinical features of the study participants were similar in both groups. Nearly 75-80% of participants had severe anxiety in the preoperative period while 10-20% had moderate anxiety. While both the drugs showed a reduction in the anxiety levels, the clonidine group fared better (statistically insignificant). The incidence of MACE was similar in both groups. CONCLUSION: The preoperative anxiety levels were high among cardiac surgery patients. Both clonidine and gabapentin were equally effective in reducing the levels of preoperative anxiety. Preoperative STAI scores in the range of 32-53 is not associated with MACE and 30-day mortality among cardiac surgery patients. Wolters Kluwer - Medknow 2022 2022-07-05 /pmc/articles/PMC9387608/ /pubmed/35799556 http://dx.doi.org/10.4103/aca.aca_80_21 Text en Copyright: © 2022 Annals of Cardiac Anaesthesia https://creativecommons.org/licenses/by-nc-sa/4.0/This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mudgalkar, Nikhil
Kandi, Venkataramana
Baviskar, Aashish
Kasturi, Ravinder Reddy
Bandurapalli, Bindusha
Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel-Group Study
title Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel-Group Study
title_full Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel-Group Study
title_fullStr Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel-Group Study
title_full_unstemmed Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel-Group Study
title_short Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel-Group Study
title_sort preoperative anxiety among cardiac surgery patients and its impact on major adverse cardiac events and mortality– a randomized, parallel-group study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9387608/
https://www.ncbi.nlm.nih.gov/pubmed/35799556
http://dx.doi.org/10.4103/aca.aca_80_21
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