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Conscious Experience and Psychological Consequences of Awake Craniotomy


Hejrati, Nader; Spieler, Derek; Samuel, Robin; Regli, Luca; Weyerbrock, Astrid; Surbeck, Werner (2019). Conscious Experience and Psychological Consequences of Awake Craniotomy. World Neurosurgery, 129:e381-e386.

Abstract

Background: Experiencing cranial surgery under awake conditions may expose patients to considerable psychological strain

METHODS: This study aimed to investigate the occurrence and course of psychological sequelae following awake craniotomy (AC) for brain tumors in a series of 20 patients using a broad, validated psychological assessment preoperatively, intraoperatively, postoperatively and a standardized follow-up of 3 months. In addition, the association of the preoperative psychological condition (including, but not limited to, anxiety and fear) with perioperative pain perception and interference was assessed.

RESULTS: AC did not induce any shift in the median levels of anxiety, depression, and stress symptoms already present prior to the procedure. Furthermore, anxiety and depression were all moderately to strongly associated over time (all P < 0.05). Stress symptoms also correlated positively over all times of measurement. Stress 3 days after surgery was strongly associated with stress 3 months after surgery (P < 0.001), whereas the correlation between preoperative and immediate postoperative stress showed a statistical trend (P = 0.07). Preoperative fear was not related to intraoperative pain, but to pain and its interference with daily activity on the third postoperative day (P < 0.001 and P < 0.01, respectively).

Abstract

Background: Experiencing cranial surgery under awake conditions may expose patients to considerable psychological strain

METHODS: This study aimed to investigate the occurrence and course of psychological sequelae following awake craniotomy (AC) for brain tumors in a series of 20 patients using a broad, validated psychological assessment preoperatively, intraoperatively, postoperatively and a standardized follow-up of 3 months. In addition, the association of the preoperative psychological condition (including, but not limited to, anxiety and fear) with perioperative pain perception and interference was assessed.

RESULTS: AC did not induce any shift in the median levels of anxiety, depression, and stress symptoms already present prior to the procedure. Furthermore, anxiety and depression were all moderately to strongly associated over time (all P < 0.05). Stress symptoms also correlated positively over all times of measurement. Stress 3 days after surgery was strongly associated with stress 3 months after surgery (P < 0.001), whereas the correlation between preoperative and immediate postoperative stress showed a statistical trend (P = 0.07). Preoperative fear was not related to intraoperative pain, but to pain and its interference with daily activity on the third postoperative day (P < 0.001 and P < 0.01, respectively).

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurosurgery
Dewey Decimal Classification:610 Medicine & health
Scopus Subject Areas:Health Sciences > Surgery
Health Sciences > Neurology (clinical)
Uncontrolled Keywords:Surgery, Clinical Neurology, Awake craniotomy; Brain tumor; Depression; Fear; Pain perception; Psychology; Stress
Language:English
Date:1 September 2019
Deposited On:17 Oct 2019 11:54
Last Modified:29 Jul 2020 11:29
Publisher:Elsevier
ISSN:1878-8750
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.wneu.2019.05.156

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