The Effects Of Preoperative Anxiety Level On Intraoperative Hemodynamics And Anesthesia Complicationgs In Patients Undergoing General Anesthesia Thyroid

Objective To investigate the effects of preoperative anxiety level on intraoperative hemodynamics and anesthesia complications in patients undergoing general anesthesia thyroid surgery.Methods The study was a double-blind,randomized,placebo-controlled trail.A total of100 female patients who aged 45-65 years,ASAⅠ^Ⅱ,undergoing thyroid surgery were enrolled.State anxiety inventory（SAI）was administered to the patients:low-anxious group（group L）and high-anxious group（group H）,The high anxiety group was randomly divided into anti-anxiety group（M group）and non anti-anxiety group（H₁）.The M group was administered with 0.05mg/Kg midazolam by intravenous injection30min before the induction of anesthesia.H group and L group were given the same amount of the N.S.After entering the operating room,the SAI score was administered to the patients again.patients were routinely tested for vital signs and the depth of anesthesia.If intraoperative SBP is lower than 20%of the baseline reading,or SBP lower than 90mmHg.8ug norepinephrine intravenous injection.If the heart rate less than 45beats per minute,was managed by iv atropine0.5mg.Three groups of patients with systolic blood pressure（SBP）、diastolic blood pressure（DBP）、heart rate（HR）and nacotrend values were recored at baseline（10 min after operating room）、T₁（10 min after induction）、T₂（30 min after operation）、T₃（10 min after extubation）.The time of surgery,anesthesia,the use of propofol,remifentanil were recored.The State anxiety inventory（SAI）scores were abtained at 1d before surgery and before anesthesia induction.The number of additional norepinephrine and atropine were recorded as well.Extubation time and complications such as nausea、vomiting、agitation were reco-red.Patients′visual analogue scores（VAS）were recored during PACU and 1、4、24h post surgery.Result Complete perioperative data was available for only 90 of the 100 patients.groupL（n=48）,groupH₁（n=21）,groupM（n=21）.1.There were no significant difference in three groups′age、height、weight、operation time、anesthesia time、liquid、blood loss、hematocrit、propofol consumption、remifentanil consumption（P>0.05）;2.Group H₁、M′values of SAI at 1d before surgery were significantly more than the Group L（P<0.05）;Group H₁′s values of SAI at preanesthesia were significantly more than the Group L、M（P<0.05）;3.The value of SBP、DBP and HR at baseline time in three groups were no statistically significant（P>0.05）.The base nacotrend values of Group M were significant lower than Group L、H₁（P<0.05）;At T_1-2-2 time,SBP、DBP and HR in Group H1、M were lower than Group L（P<0.05）;At T₃ time,three groups of SBP、DBP and HR were no statistically significant（P>0.05）.4.Compared with Group L,the number of cases of application atropine and norepinephrine in Group H₁、M were more than Group L（P<0.05）;5.There were no significant difference in three groups′extubation time,nausea and vomiting（P>0.05）;In Group H_1,more agitation were found（P<0.05）;6.Pain scores during PACU were not statistically significant（P>0.05）;Pain scores at 1、4h post surgery of Group H₁ more than Group L、M（P<0.05）;Pain scores at 24h post surgery of Group H₁、M more than Group L（P<0.05）.Conclusions Preoperative high-anxious level dose significantly decrease the hemodynamic parameters during general anesthesia,negatively influence the experience of agitation and postoperative pain.Preoperative midazolam anti-anxiety treatment can reduce the experience of agitation and the postoperative earlier pain,it dose not improve the hemodynamic parameters.