TY - JOUR
T1 - Intraoperative panic attack in patients undergoing awake craniotomy
T2 - a retrospective analysis of risk factors
AU - Kamata, Kotoe
AU - Maruyama, Takashi
AU - Komatsu, Ryu
AU - Ozaki, Makoto
N1 - Funding Information:
Dr. Takashi Maruyama helped to design the study and to write the manuscript. Dr. Ryu Komatsu helped to interpret the data and provided valuable expertise in writing the manuscript. Dr. Makoto Ozaki helped to design the study and helped to write the manuscript. The authors would like to acknowledge Dr. Yoko Uchiide (Certified psychiatrist) for giving a wide range of views in the psychiatric field. The authors are also indebted to Dr. Satoru Shimizu (School of Arts and Sciences, Tokyo Woman's Christian University) for his expert advice about statistical analysis. The authors would also like to acknowledge Dr. Yoshihiro Muragaki (Department of Neurosurgery, Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University), Dr. Takakazu Kawamata (Department of Neurosurgery, Tokyo Women's Medical University), Dr. Masayuki Nitta (Department of Neurosurgery, Tokyo Women's Medical University), Dr. Taiichi Saito (Department of Neurosurgery, Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University), and Dr. Manabu Tamura (Department of Neurosurgery, Faculty of Advanced Techno-Surgery, Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University) for their valuable cooperation.
Publisher Copyright:
© 2021, Japanese Society of Anesthesiologists.
PY - 2021/12
Y1 - 2021/12
N2 - Purpose: Intraoperative anxiety is the most common psychological response of the patient during awake craniotomy. Psychological stress can trigger patient decline, resulting in failed awake craniotomy and significantly poor outcomes. This study aimed to identify the risk factors for panic attack (PA) during awake craniotomies. Methods: With the local ethics committee approval, we conducted a manual chart review of the medical record of patients who underwent consecutive awake craniotomies between November 1999 and October 2016 at Tokyo Women's Medical University. A total of 405 patients were identified and assigned to 2 groups based on the Diagnostic and Statistical Manual of Mental Disorders-V criteria: those that met the PA criteria (Group PA) and those that did not (Group non-PA). Patient characteristics and the incidence of the PA specifier were collected. The features of the two groups were statistically compared, and risk factors for PA occurrence were determined by regression analysis. Results: Sixteen of 405 patients met the diagnostic criteria of PA. Patients' characteristics were not statistically different between the groups. Multivariate logistic regression showed that intraoperative anxiety (p = 0.0002) and age younger than 39 years (as opposed to age > = 39 years; p = 0.0328) were significantly associated with the occurrence of PA during awake craniotomy. Conclusions: For patients undergoing awake craniotomy, intraoperative anxiety and age younger than 39 years were considered risk factors of PA. As PA often necessitates conversion to general anesthesia, intensive perioperative psychological support and pain management are required to achieve patient satisfaction and the surgical goal of awake craniotomy.
AB - Purpose: Intraoperative anxiety is the most common psychological response of the patient during awake craniotomy. Psychological stress can trigger patient decline, resulting in failed awake craniotomy and significantly poor outcomes. This study aimed to identify the risk factors for panic attack (PA) during awake craniotomies. Methods: With the local ethics committee approval, we conducted a manual chart review of the medical record of patients who underwent consecutive awake craniotomies between November 1999 and October 2016 at Tokyo Women's Medical University. A total of 405 patients were identified and assigned to 2 groups based on the Diagnostic and Statistical Manual of Mental Disorders-V criteria: those that met the PA criteria (Group PA) and those that did not (Group non-PA). Patient characteristics and the incidence of the PA specifier were collected. The features of the two groups were statistically compared, and risk factors for PA occurrence were determined by regression analysis. Results: Sixteen of 405 patients met the diagnostic criteria of PA. Patients' characteristics were not statistically different between the groups. Multivariate logistic regression showed that intraoperative anxiety (p = 0.0002) and age younger than 39 years (as opposed to age > = 39 years; p = 0.0328) were significantly associated with the occurrence of PA during awake craniotomy. Conclusions: For patients undergoing awake craniotomy, intraoperative anxiety and age younger than 39 years were considered risk factors of PA. As PA often necessitates conversion to general anesthesia, intensive perioperative psychological support and pain management are required to achieve patient satisfaction and the surgical goal of awake craniotomy.
KW - Anxiety
KW - Awake craniotomy
KW - Complications
KW - Panic attack
KW - Psychological responses
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U2 - 10.1007/s00540-021-02990-0
DO - 10.1007/s00540-021-02990-0
M3 - Article
C2 - 34402974
AN - SCOPUS:85112749013
VL - 35
SP - 854
EP - 861
JO - Journal of Anesthesia
JF - Journal of Anesthesia
SN - 0913-8668
IS - 6
ER -