Ansiedad prequirúrgica en pacientes adultos sometidos a cirugía traumatológica: propuesta de un protócolo pre anestésico
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2016
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
Una de las emociones más comunes es la llamada ANSIEDAD, biológicamente heredada con la finalidad de preservar la especie, caracterizada por sentimientos de nerviosismo, aprensión, tensión y preocupación, desencadenando de esta manera la activación y descarga del Sistema nervioso autónomo con todas sus manifestaciones clínicas, Cuando un paciente experimenta estas sensaciones y mas aún exacerbadas por el ingreso hospitalario, sus síntomas aumentan la morbilidad pre quirúrgica y post operatoria.
Este estudio tiene como objetivo elaborar un protocolo pre anestésico, que será validado por un experto, para el control de la ansiedad pre quirúrgica en uno de los grupos más afectados como son los pacientes traumatológicos, a fin de poder realizar diagnósticos tempranos y tratamientos oportunos para el control de esta patología, teniendo como cimiento la fundamentación teórica y basándose en las categorías médicas, sociales, psicológicas, económicas y éticas.
Utilizando la metodología cualitativa por medio de estudio de casos, con la descripción de todas las categorías, y formulando la pregunta científica se obtuvieron los siguientes resultados: La mayoría de los pacientes adultos que iban a ser sometidos a cirugías traumatológicas por dolencias agudas o crónicas, manifestaron padecer ansiedad, lo que concuerda con el porcentaje internacional ( 20 – 80%), los pacientes mas ansiosos sufrieron mas eventos adversos, y necesitaron mas analgésicos y más dosis de sedación, la aplicación del test de APAIS para valorar el estado de ansiedad, fue el ideal en estos pacientes traumatológicos por ser sencillo y rápido. Y se puede aplicar antes del procedimiento quirúrgico y además permite el diagnóstico precoz y un tratamiento oportuno para brindar mayor atención al paciente más ansioso. La edad de los pacientes traumatológicos con mayor grado de ansiedad fue entre 20 y 45 años, y además la vista pre- anestésica genera un vinculo de confianza entre el paciente y su anestesiólogo disminuyendo el nivel de estrés.
One of the most common emotions is called ANXIETY , biologically inherited in order to conserve the species , characterized by feelings of nervousness, apprehension, tension and worry, this triggers the activation and download the autonomic nervous system with all its clinical manifestations , when a patient experiences these feelings and even more exacerbated by hospital admission , symptoms increase pre and postoperative surgical morbidity. This study aims to develop a pre anesthetic protocol, which will be validated by an expert, to control the presurgical anxiety in one of the groups most affected such as trauma patients, in order to make early diagnosis and treatment for control presurgical anxiety. Based on the theoretical basis and based on the medical, social, psychological, economic and ethical categories. Using qualitative methodology through case studies, with the description of all categories, and formulating the scientific question the following results were obtained: Most adult patients who were to undergo orthopedic surgery for acute or chronic ailments, expressed suffering from anxiety, consistent with international percentage (20-80%), the most anxious patients experienced more adverse events, and needed more painkillers and more doses of sedation, the application of test APAIS to assess the state of anxiety, it was the ideal in these trauma patients to be simple and fast. And it can be applied before the surgical procedure and allows early diagnosis and timely to give more attention to the more anxious patient treatment. The age of patients with major trauma anxiety level was between 20 and 45, and also the anesthetic pre- view generates a bond of trust between the patient and the anesthesiologist decreasing the level of stress.
One of the most common emotions is called ANXIETY , biologically inherited in order to conserve the species , characterized by feelings of nervousness, apprehension, tension and worry, this triggers the activation and download the autonomic nervous system with all its clinical manifestations , when a patient experiences these feelings and even more exacerbated by hospital admission , symptoms increase pre and postoperative surgical morbidity. This study aims to develop a pre anesthetic protocol, which will be validated by an expert, to control the presurgical anxiety in one of the groups most affected such as trauma patients, in order to make early diagnosis and treatment for control presurgical anxiety. Based on the theoretical basis and based on the medical, social, psychological, economic and ethical categories. Using qualitative methodology through case studies, with the description of all categories, and formulating the scientific question the following results were obtained: Most adult patients who were to undergo orthopedic surgery for acute or chronic ailments, expressed suffering from anxiety, consistent with international percentage (20-80%), the most anxious patients experienced more adverse events, and needed more painkillers and more doses of sedation, the application of test APAIS to assess the state of anxiety, it was the ideal in these trauma patients to be simple and fast. And it can be applied before the surgical procedure and allows early diagnosis and timely to give more attention to the more anxious patient treatment. The age of patients with major trauma anxiety level was between 20 and 45, and also the anesthetic pre- view generates a bond of trust between the patient and the anesthesiologist decreasing the level of stress.
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Ansiedad, Periodo preoperatorio, Pacientes hospitalizados, Traumatología, Protocolos, Anestésicos, Omnihospital, Cantón Guayaquil, Ecuador