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Postanesthesia emergence in patients with post-traumatic stress disorder
- Source :
- Journal of Clinical Anesthesia. 34:3-10
- Publication Year :
- 2016
- Publisher :
- Elsevier BV, 2016.
-
Abstract
- Study objective Recovery from anesthesia may be complicated with development of severe panic symptoms and anxiety. Preexisting anxiety disorder has been reported as a risk factor for development of these symptoms. We aimed to examine the frequency of emergence delirium (EDL) among veterans diagnosed with posttraumatic stress disorders (PTSDs). Design Retrospective cohort. Setting Postoperative recovery area. Patients Perioperative information of 1763 consecutive patients who underwent a surgical procedure requiring general anesthesia were collected. The patients were grouped on the basis of previous diagnosis of PTSD. A total of 317 patients were identified with a positive history of PTSD and were compared to 1446 patients without such a history for the occurrence of EDL in the postanesthesia care unit (PACU) as the primary endpoint. Measurements Duration of stay in PACU in minutes and the frequency of hospital admission were the secondary endpoints. Multivariate binary logistic regression analysis was performed to identify the predictors of EDL among the veteran population. Main results Emergence delirium was reported in 37 cases (2.1%) after general anesthesia. Fifteen (4.7%) of 317 patients with PTSD and 22 (1.5%) of 1446 patients without history of PTSD demonstrated symptoms related to EDL in the PACU ( P =.002). After propensity matching, there were 8 patients with EDL in the PTSD group whereas there were only 2 patients with EDL among controls. Posttraumatic stress disorder was also an independent predictor of EDL in multivariate analysis with an odds ratio of 6.66 and a 95% confidence interval of 2.04 to 21.72 ( P =.002). Conclusions Posttraumatic stress disorder independently predicted the frequency of EDL even after correcting for preexisting depression and anxiety disorders. A relatively longer duration of PACU stay in PTSD patients may reflect raised awareness of the health care workers about this debilitating mental disorder.
- Subjects :
- Male
Population
Anesthesia, General
Anxiety
Pacu
Stress Disorders, Post-Traumatic
03 medical and health sciences
Emergence Delirium
0302 clinical medicine
Risk Factors
030202 anesthesiology
Humans
Medicine
Etomidate
030212 general & internal medicine
education
Aged
Retrospective Studies
Veterans
education.field_of_study
biology
Depression
business.industry
Traumatic stress
Retrospective cohort study
Perioperative
Length of Stay
Middle Aged
medicine.disease
biology.organism_classification
Anxiety Disorders
Panic
Anesthesiology and Pain Medicine
Emergence delirium
Anesthesia
Anesthesia Recovery Period
Multivariate Analysis
Female
medicine.symptom
business
Anesthetics, Intravenous
Anxiety disorder
Subjects
Details
- ISSN :
- 09528180
- Volume :
- 34
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Anesthesia
- Accession number :
- edsair.doi.dedup.....02e799f611c7ce59b45a8ce8a9ab0431