title: [Perioperative pain and anxiety in endoscopic sinus surgery].
abstract: BACKGROUND
  Aim of this study was to evaluate the perioperative level of pain and anxiety for endoscopic sinus surgery, and to compare 3 different types of nasal packing.
  
  
  METHODS
  Prospective, controlled, randomized study comparing different types of nasal packing in regard to perioperative anxiety and pain. Patients suffered from chronic rhinosinusitis with nasal polyps involving all paranasal sinuses. Patients daily evaluated by standardized questionnaires (FPI-R, KASA, STAI) and also visual analog scale for pain on 5 consecutive days before and after endoscopic sinus surgery of all paranasal sinuses. Nasal packings were removed on 2(nd) postoperative day.
  
  
  RESULTS
  A total of 73 patients (polyvinyl acetate packing N = 14, glove packing N = 37, glove packing with breathing tubes N = 22) completed the study. Female gender, bad preoperative mood and absence of pain were associated with increased preoperative state anxiety based on regression analysis. Also, preoperative gathering of additional information from relatives and friends was correlated with increased preoperative anxiety. Patients had significantly minor preoperative anxiety if they could expect use of nasal packings with breathing tubes.
  
  
  CONCLUSIONS
  Female patients, who gathered information about the operation from friends or relatives or patient in worse preoperative mood are at risk for increased state anxiety and should be identified prior to rhinosurgical procedures. Use of nasal packing with at least partially preserved nasal breathing is recommended in clinically anxious patients.
authors.affiliation: Klinik für Hals-, Nasen-, Ohrenkrankheiten, Kopf- und Hals-Chirurgie, Universitätsklinikum Greifswald, D-17475 Greifswald, Germany. hosemann@uni-greifswald.de
authors.forename: W
authors.initials: W
authors.lastname: Hosemann
authors.forename: T H
authors.initials: TH
authors.lastname: Loew
authors.forename: M
authors.initials: M
authors.lastname: Forster
authors.forename: T
authors.initials: T
authors.lastname: Kühnel
authors.forename: A G
authors.initials: AG
authors.lastname: Beule
mesh_terms: D000328:Adult; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology*; D002908:Chronic Disease; D003469:Culture; D004724:Endoscopy / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000523:psychology* / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000523:psychology*; D010254:Paranasal Sinus Diseases / Q000523:psychology* / Q000601:surgery*; D011446:Prospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012852:Sinusitis / Q000523:psychology* / Q000601:surgery*; D011795:Surveys and Questionnaires; D013630:Tampons, Surgical