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Effects of preoperative psychological intervention on early postoperative cognitive dysfunction after off-pump coronary artery bypass surgery

Background: This study aims to evaluate the effect of preoperative psychological intervention on the prevalence of early Postoperative Cognitive Dysfunction (POCD) in patients undergoing Off-Pump Coronary Artery Bypass Surgery (OPCAB).

Materials and Methods: Two groups of 1:1 paired patients (34 cases each) who underwent selective OPCAB were enrolled. One group received targeted preoperative psychological intervention (the intervention group), while the other group did not (the control group). Levels of preoperative anxiety before and after psychological intervention were evaluated using the Self-Rating Anxiety Scale (SAS). Occurrence of POCD on postoperative days 1, 3, 5, 7, and 14 was examined using Mini-Mental State Examination (MMSE). Enumeration and measurement data were compared between groups using χ2 test and paired t-test, respectively.

Results: The results indicated that there was no significant difference between patients of the intervention and control groups regarding gender, age, baseline SAS score, cardiac function, operation time, anaesthesia time, and intensive care unit length of stay (p>0.05). After psychological intervention, preoperative SAS score of the intervention group became significantly lower than that of the control group (50.91 ± 3.54 vs. 66.76 ± 3.18, p<0.05), and the prevalence of POCD was significantly lower in the former than in the latter group on postoperative days 3 (4/34 vs. 9/34), 5 (5/34 vs. 11/34), and 7 (5/34 vs. 10/34) (p<0.05).

Conclusion: Preoperative psychological intervention significantly alleviates anxiety and effectively reduces the prevalence of early POCD in patients undergoing OPCAB.

Author(s): Zhan Shi, Jianxiang Song, Huiwen Chang, Yajun Zhang