|Title:||Mirtazapine, in orodispersible form, for patients with preoperative psychological distress: A pilot study||Authors:||Chou W.-H.
|Issue Date:||2016||Publisher:||Elsevier Taiwan LLC||Journal Volume:||54||Journal Issue:||1||Start page/Pages:||16-23||Source:||Acta Anaesthesiologica Taiwanica||Abstract:||
Background: Perioperative psychological distress is associated with preoperative anxiety, depression, and postoperative pain. Mirtazapine is effective as an antidepressant, anxiolytic agent, and sleep enhancer. Moreover, mirtazapine can be made as orodispersible tablets with a fast onset for patients in nil per os status. This study is to determine whether mirtazapine can help psychologically distressed patients reduce perioperative anxiety, depression, and postoperative pain. Materials and methods: Patients with preoperative psychological distress, undergoing major abdominal surgery, were inquired and assigned to two groups according to their own choice. In the treatment group, patients could choose to take orodispersible mirtazapine 30 mg at each night from Preoperative Day 0 to Postoperative Day 3. There was no other intervention in the nontreatment group. Hospital Anxiety and Depression Scale (HADS), Athens Insomnia Scale (AIS), and pain scores were accessed on the day before operation (Day 0), and on the 1st day (Day 2) and 3rd day (Day 4) after operation. We compared the HADS, AIS, and pain scores, and morphine consumptions between the two groups on a daily basis. Marginal regression models were fitted to our correlated longitudinal data alone with the generalized estimating equations method to estimate the population average effects of time-varying mirtazapine usage on the mean values of HADS, AIS, and pain scores, and daily morphine consumptions. Results: From September 2007 to December 2008, 86 patients agreed to be enrolled and 79 of them completed the study. Propensity scores and multivariate analysis showed that mirtazapine reduced HADS scores of patients in 2 days. Trial results indicated that mirtazapine lowered the AIS day index and tended to decrease night index as well. Mirtazapine may reduce patients' morphine consumption, but this effect was not statistically significant (p = 0.2). Conclusion: Mirtazapine helps reduce anxiety, depression, and insomnia scores for patients with perioperative psychological distress. Copyright ? 2016, Taiwan Society of Anesthesiologists. Published by Elsevier Taiwan LLC.
|ISSN:||1875-4597||DOI:||10.1016/j.aat.2015.12.002||SDG/Keyword:||mirtazapine; morphine; mianserin; mirtazapine; tricyclic antidepressant agent; abdominal surgery; adult; age; anxiety disorder; Article; Athens Insomnia Scale; cancer surgery; depression; distress syndrome; dizziness; drug use; female; gender; Hospital Anxiety and Depression Scale; human; major clinical study; male; pain assessment; patient controlled analgesia; pilot study; postoperative pain; postoperative period; preoperative period; propensity score; sleep disorder assessment; surgical patient; surgical stress; vomiting; xerostomia; aged; analogs and derivatives; anxiety disorder; depression; middle aged; preoperative period; Adult; Aged; Antidepressive Agents, Tricyclic; Anxiety Disorders; Depressive Disorder; Female; Humans; Male; Mianserin; Middle Aged; Pilot Projects; Preoperative Period; Propensity Score
|Appears in Collections:||醫學院附設癌醫中心醫院(臺大癌醫)|
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