Acil Servise Akut Ağrı Sebebiyle Başvuran Hastalarda Anksiyete Düzeyindeki Değişimin Ağrı Algısı Üzerindeki Etkisinin Saptanması: Randomize Kontrollü, Çift kör Çalışma

Year 2023, , 7 - 12, 08.03.2023

Asım Enes Özbek , Murat Pekdemir , Asim Tomo , Hüseyin Acar , Ümit Tural

https://doi.org/10.54996/anatolianjem.1075136

Abstract

Amaç: Çalışmanın amacı, acil servise akut ağrı sebebiyle başvuran hastaların ağrı ve anksiyete düzeylerini belirleyip standart ağrı kesici tedaviye ek olarak anksiyolitik tedavi vermenin ağrı ve anksiyete düzeyleri üzerindeki etkisini araştırmaktır.

Gereç ve Yöntemler: Bu çalışma prospektif, randomize, çift kör bir klinik çalışmadır. Çalışma grubuna deksketoprofen trometamol ve midazolam verilirken, kontrol grubuna sadece deksketoprofen trometamol verildi. Tedavinin 0, 30, 60 ve 120. dakikalarında hastanın ağrı ve anksiyete düzeyleri ölçüldü. Hastaların genel anksiyete düzeyleri ölçüldü. Birincil sonuç ölçümü hastaların 0-30. dakikalardaki ağrı değişimidir.

Bulgular: Çalışmada her gruba 90 hasta dahil edildi. Çalışma grubunda ağrı değişim medyanı 30 (IQR, 33), kontrol grubunda 33.5 (IQR, 38) tespit edildi. Ortalama değişim 3.5 (95% CI; -7.2 - 14.2) olarak saptandı. Çalışma grubunda anksiyete değişim medyanı 20 (IQR, 40), kontrol grubunda 9.5 (IQR, 41) tespit edildi. Ortalama değişim -10.5 (95% CI; -24.37 to 3.37) olarak saptandı. Kurtarıcı tedavi ihtiyacı, tedavi memnuniyeti ve uygulanan tedaviyi gelecekte de isteme oranları gruplar arasında benzerdi (26.7% vs 40%, p=0.058; 64% vs 57%, p=0.770; 90% vs 89%, p=0.802).

Sonuç: Acil servise akut ağrı şikayetiyle başvuran hastalarda ağrı kesici tedaviye anksiyolitik tedavi eklemek ağrı ve anksiyete düzeylerinin azalmasına katkı sağlamamaktadır.

Keywords

Akut ağrı, anksiyete, acil tıp, ağrı yönetimi

Determination of the Effects of Change in Anxiety Level on Pain Perception in Patients who Present to Emergency Department due to Acute Pain: A Double Blind, Randomized, Controlled Trial

Abstract

Aim: The aim of this study is to determine the level of pain and anxiety, and to investigate the effect of standard analgesic treatment and additional anxiolytic treatment on pain and anxiety in patients who presented to the emergency department due to acute pain.

Material and Methods: This is a prospective, randomized, controlled, double-blind study. As the study group received dexketoprofen trometamol plus midazolam, the control group received dexketoprofen trometamol alone. At 0th, 30th, 60thand 120th minutes of treatment, patients' pain and anxiety levels were measured. Patients' overall anxiety levels were measured. The primary outcome measure was the comparison of pain and anxiety change at 0-30 minutes.

Results: The study was conducted with 90 patients in each group. The median pain change was 33.5 (IQR, 38) for the control group and 30 (IQR, 33) for the study group, and the mean difference was 3.5 (95% CI; -7.2 to 14.2). The median anxiety change was 9.5 (IQR, 41) for the control group and 20 (IQR, 40) for the study group, and the mean difference was -10.5 (95% CI; -24.37 to 3.37). The rescue therapy needed, treatment satisfaction and preference to the same treatment in the future were similar between the control and the study group, respectively (26.7% vs 40%, p=0.058; 64% vs 57%, p=0.770; 90% vs 89%, p=0.802).

Conclusion: In patients who present to the emergency department due to an acute pain complaint, adding anxiolytic treatment to the analgesic treatment does not contribute to a reduction of pain and anxiety.

Keywords

Acute pain, anxiety, emergency department, pain management

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