engleski

Effects of preoperative anxiety, depression and pain on quality of postoperative recovery after radical prostatectomy

Objectives: Patients with prostate cancer are often in psychological stress and pain preoperatively. The aim of this study was to examine effects of preoperative depression, anxiety and pain on quality of postoperative recovery after radical prostatectomy. Methods: One hundred and sixty patients scheduled for radical retropubic (72/160) or laparoscopic prostatectomy (88/160) were enrolled in a prospective observational study. Psychological stress and pain were assessed with State-Trait Anxiety Inventory (STAI-S and STAI-T), Center for Epidemiological Studies Depression Scale (CES-D) and Brief Pain Inventory Scores Worst (BPI-W), Severity (BPI-S) and Interference (BPI-I). Postoperative recovery was assessed on days 1-3 using the Quality of recovery40 score (QoR-40). Numeric rating scale 0-11 was used to assess the intensity of postoperative pain at rest (NRS-R) and movement (NRS- M) at 1, 6 and 24h post-surgery. Intravenous tramadol, paracetamol and ketoprofen were used for postoperative analgesia. Results: Preoperatively, mean (SD) STAI-S, STAI-T and CES-D scores were 36.4(10.2), 34.5 (9.1) and 10.3 (9.2), respectively, with significant negative correlations with QoR-40 scores on 1st to 3rd postop. day (r -0.30 to -0.47 ; P<0.05). QoR-40 scores on days 1-3 were 164.0(15.9), 176.6 (14.5) and 183.5 (12.3) respectively. Mean (SD) BPI-W, BPI-S and BPI-I scores were 3.4 (1.5), 2.3 (1.1) and 2.0 (1.2) respectively. NRS-R scores at 1, 6, 24 h were 2.8 (2.1), 2.8 (1.6) and 2.4 (1.8) and NRS- M scores at 1, 6, 24 h were 4.2 (2.1), 4.3 (1.7) and 4.2 (1.7) respectively. BPI-W and BPI-S had significant positive correlations with NRS-R and NRS- M at 6h (r 0.42 to 0.53 ; P<0.05). BPI scores did not correlate with QoR-40 scores. Conclusion: Preoperative anxiety and depression had negative correlation with postoperative quality of recovery after radical prostatectomy. Preoperative pain correlated with postoperative pain at 6h but did not affect quality of postoperative recovery assessed with QoR-40.

anxiety ; depression ; pain ; quality of postoperative recovery ; radical prostatectomy

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