The Effect Of Preoperative Anxiety On Postoperative Delirium After General Anesthesia In Elderly Patients

Objective:To observe the effect of of preoperative anxiety on postoperativedelirium after general anesthesia in elderly patients.Method:One hundred and twenty two patients aged from65years to75yearsold,ASA1-2who undergone the elective operation were divided into twogroups:Group1and Group2.The patients of Group1had received first surgery. Thepatients of Group2had the history of surgery. The patients received the electivesurgerys: orthopedics surgery and gynaecology surgery group and general surgerygroup.The Group1had sixty-two cases,the Group2had60cases. All of the patientswere given operative visit on the one day before the operation.We evaluated thecognitive function by means of MMSE (Mini-Mental State Examination).We alsoevaluated the preoperative anxiety by means of STA-S.In both groups, anesthesia was induced withmidazolam0.03-0.05mg/kg,sufentanil0.3-0.5ug/kg,cisatracurium0.2mg/kg,etomidate0.3mg/kg.During the operation,propofol and remifentanil were given tomaintain anesthesia.We monitor MAP,HR,SpO2,BIS and ABP, CVP, CO if necessaryduring the operation.After the operation, we evaluated the pain of degree of all thepatients by VAS at the day of surgery and1day,2days and3days.We also evaluatedand diagnosed the postoperative delirium on the CAM rules on1day,2days and3days.Results: We calculated and analysis the preoperative anxiety to the postoperativedelirium relative risk. The relative risk of first surgery group(group1) is1.9andoperation history surgery group(group2) is1.125.We also found that the anxiety ofpatients who taken first operation is more than the patients who had taken once or more operation.Conclusion: The morbidity of postoperative delirium in the group that the patientswho had preoperative anxiety is higher than the group that the patients who had notpreoperative anxiety.