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Pharmacologic and Nonpharmacologic Interventions for Perioperative Anxiety in Patients Undergoing Mohs Micrographic
Angie Y Wan1, Mark Biro, Jeffrey F Scott
1All authors are affiliated with the Department of Dermatology, University Hospitals Case Medical Center, Cleveland, Ohio.
Background:
Perioperative anxiety is associated with negative patient outcomes in Mohs micrographic surgery (MMS). Both pharmacologic and nonpharmacologic therapies have been used to alleviate perioperative anxiety in MMS.
Objective:
To systematically evaluate the efficacy of therapies aimed at reducing perioperative anxiety in MMS.
Methods And Materials:
Eligible articles were identified using PubMed MEDLINE, Cochrane Central Register of Controlled Trials, metaRegister of Controlled Trials, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform. All available studies investigating interventions to reduce perioperative anxiety during MMS were considered.
Results:
Of the 183 abstracts identified and screened, 5 studies met inclusion criteria. Three studies reported a postintervention reduction in patient anxiety (midazolam, educational video, and personalized music). Two studies reporting on similar interventions did not find an effect.
Conclusion:
There is currently limited evidence to support either pharmacologic or nonpharmacologic therapy for alleviation of perioperative patient anxiety in MMS. Midazolam may provide patients a short-term benefit, though any estimate of the effect is very uncertain. Personalized music may be a promising nonpharmacologic intervention for future research.
Insights
Limited evidence supports therapies for perioperative anxiety in Mohs micrographic surgery (MMS). Midazolam may offer short-term relief, while personalized music shows promise for future research in managing MMS patient anxiety.
Area of Science:
- Dermatology
- Psychology
- Surgery
Background:
- Perioperative anxiety negatively impacts patient outcomes in Mohs micrographic surgery (MMS).
- Various pharmacologic and nonpharmacologic therapies have been explored to manage anxiety during MMS procedures.
Purpose of the Study:
- To systematically evaluate the effectiveness of interventions designed to reduce perioperative anxiety in patients undergoing MMS.
Main Methods:
- Searched major databases (PubMed MEDLINE, Cochrane, ClinicalTrials.gov, WHO ICTRP) for relevant studies.
- Included all studies investigating interventions for perioperative anxiety during MMS.
Main Results:
- Five studies met inclusion criteria from 183 screened abstracts.
- Three studies showed reduced anxiety with midazolam, educational videos, or personalized music.
- Two studies found no significant effect from similar interventions.
Conclusions:
- Current evidence for pharmacologic and nonpharmacologic anxiety alleviation in MMS is limited.
- Midazolam may provide a short-term benefit, but its effect is uncertain.
- Personalized music presents a potential nonpharmacologic option for future investigation.
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