VISUAL ANALOGUE SCALE AS A TOOL FOR ASSESSING QUALITY OF LIFE (PEDSQL™) AND EMOTIONAL STRESS IN CHILDREN AFTER ANTERIOR ABDOMINAL WALL SURGERY

Y. Semkovych, D. Dmytriiev
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Abstract

Introduction. The prevalence of chronic postsurgical pain can be as high as 54%. Almost 17% of adult chronic pain patients report a history of chronic pain in childhood or adolescence. Untreated chronic pain in children increases the risk of developing mental disorders later in life. Health-related quality of life (HRQoL) is a commonly used indicator of health and well-being that demonstrates the impact of health on quality of life and reflects the desirability of health states relative to perfect health. The simplicity, reliability, validity, and easy determination of visual analogue scale (VAS) scores provides for its wide-ranging application in various clinical cases. The aim of this study was to assess quality of life in children after anterior abdominal wall surgery using the PedsQL™ 3.0 Present Functioning Visual Analogue Scales. Materials and Methods. Following the inclusion and exclusion criteria, a total of 80 children undergoing treatment at the surgical department of a Communal Non-Profit Enterprise “Ivano-Frankivsk Regional Children’s Clinical Hospital of Ivano-Frankivsk Regional Council” were enrolled in the study. Among them, 60 children underwent anterior abdominal wall surgery with various types of anesthetic regimens. The patients were asked to fill in the questionnaires repeatedly three and six months after hospital discharge. Results. According to the VAS, three and six months after surgery, quality of life was significantly lower in children who underwent anterior abdominal wall surgery under general anesthesia with opioids and were diagnosed with chronic pain syndrome (p<0.01). Their quality of life was significantly lower due to excessive emotional stress secondary to chronic pain syndrome (p<0.001). Discussion. Three months after surgery, children with chronic pain syndrome who underwent conventional anesthesia had high VAS scores experiencing reduced quality of life and elevated emotional stress as compared to the control group (p<0.001). Six months after surgery, in children who underwent regional analgesia, the levels of quality of life and emotional stress almost approached those in the control group as compared to children who underwent conventional anesthesia (p<0.001). Conclusions. Chronic pain syndrome reduced quality of life in children at the age of 7-18 years who underwent anterior abdominal wall surgery by increasing overall emotional stress. The myofascial block in conjunction with general anesthesia accelerates patient’s recovery, relieves pain, and reduces emotional stress.
视觉模拟量表作为评估前腹壁手术后儿童生活质量(pedsql™)和情绪压力的工具
介绍。慢性术后疼痛的患病率可高达54%。近17%的成人慢性疼痛患者报告在儿童期或青春期有慢性疼痛史。儿童慢性疼痛得不到治疗会增加日后患精神疾病的风险。与健康有关的生活质量(HRQoL)是一种常用的健康和福祉指标,它表明健康对生活质量的影响,反映了相对于完美健康的健康状态的可取性。视觉模拟量表(visual analogue scale, VAS)评分方法简单、可靠、有效、易于确定,为其在各种临床病例中的广泛应用提供了条件。本研究的目的是使用PedsQL™3.0当前功能视觉模拟量表评估前腹壁手术后儿童的生活质量。材料与方法。根据纳入和排除标准,共有80名儿童在社区非营利性企业"伊万诺-弗兰科夫斯克地区议会的伊万诺-弗兰科夫斯克地区儿童临床医院"的外科部门接受治疗,并被纳入研究。其中60例患儿行前腹壁手术,采用不同麻醉方案。分别于出院后3个月和6个月对患者进行问卷调查。VAS评分显示,在阿片类药物全麻下行前腹壁手术并诊断为慢性疼痛综合征的患儿,术后3个月和6个月的生活质量明显降低(p<0.01)。他们的生活质量因继发于慢性疼痛综合征的过度情绪压力而显著降低(p<0.001)。术后3个月,与对照组相比,接受常规麻醉的慢性疼痛综合征患儿VAS评分较高,生活质量下降,情绪压力升高(p<0.001)。术后6个月,与常规麻醉患儿相比,局部镇痛患儿的生活质量和情绪压力水平几乎接近对照组(p<0.001)。慢性疼痛综合征通过增加整体情绪压力降低了7-18岁接受前腹壁手术的儿童的生活质量。肌筋膜阻滞配合全身麻醉可加速病人恢复,减轻疼痛,减少情绪压力。
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