| Abstract [eng] |
Introduction: Anxiety can be described as a feeling of worry, irritability, uncertainty and fear about the upcoming events. Anxiety occurs in up to 50% of anesthesiology and intensive care patients and persists even after discharge from the hospital. These patients stays in the hospital longer and are often re-hospitalized. Most often, benzodiazepines are used to manage anxiety, but due to their negative effects, non-pharmacological means of reducing anxiety are increasingly being used. Review: Sociodemographic, psychosocial risk factors and the type of surgery and anesthesia are important for the development of anxiety. High anxiety levels affect both the patient's psychological and somatic state and can affect anesthesia, surgery, postoperative course and rehabilitation. Anxiety assessment schemes should be simple, specific and sensitive for easy application in clinical practice but at the same time reliably measure the intensity and severity of anxiety. Anxiety management in anesthesiology and intensive care is broadly divided into pharmacological and non-pharmacological. Currently, benzodiazepines, such as midazolam, is the most often used pharmacological treatment. However, medications can cause breathing problems, drowsiness, delirium and interact with anesthetic drugs and prolong wakefulness, so non-pharmacological measures are increasingly being considered. These include good communication with the patient and providing information about the procedure, music therapy, aromatherapy, massage, hypnosis, meditation and imagery relaxation therapy. Music, massage, and virtual reality have been found to have the biggest effect while also being cost-effective, minimally invasive and low-risk. Conclusions: Anxiety is a common problem among anesthesiology and intensive care patients, often arising from fear of the unknown, pain and complications. Uncontrolled anxiety can worsen patient outcome, increase the amount of prescribed medication and prolong the hospitalization time. Anesthetists and nurses play a key role in managing patient anxiety through pre-operative education, communication, psychological support, various relaxation methods, environmental modification and medication. Therefore, addressing this problem requires collaboration between health care professionals from different fields. Further research on this topic is necessary to better understand the underlying mechanisms of anxiety in the intensive care unit and anesthesiology and to develop and adapt effective assessment schemes and management techniques. |
