The Influence Of Combined Usage Of Psychological Intervention And Midazolum On Stress Reaction Of Patients Undergoing Elective Surgery

IntroductionWith the development of medicine, our medical mode has been changing from the old biological mode to bio - psycho - social mode , and people attach greater importance to the influence of psychological factors on human health . As one of psychological stressors, the surgery often leads patients to acute preopera-tive psychological stress reaction . Moreover it could affect the progress and effect of the operation, and even leads to anesthesia or surgery accident. Through obversing the changes of hemodynamics , SAS and S - AI scores, and cortisol and Angiotension II concentrations in blood of patients undergoing elective surgery, we studied the influence of combined usage of psychological intervention and midazolum on stress reaction of patients undergoing elective surgery.Methods90 ASA I or II patients aged 30 - 58yr undergoing myona of uterus or benign ovarioncus were given combined spinal epidural anesthesia . With the random number table, we divided the patients into three groups, and each group had 30 ones. The concrete contented as follows: Contrast group(D);preopera-tive routine visiting , no premedication;Midazolum group ( M): preoperative routine visiting ,and preoperative intramascular injection of midazolum 0. 05mg/ kg 30 minutes before the operation;Midazolum and psychological intervention group ( D + M) : preoperative visiting by the assays of psychological intervention, and preoperative intramascular injection of midazolum 0. 05mg/kg before the operation. Then on visiting day and operation day , the data of MAP. HR. andSpO2 were recored by the professional anesthetist , SAS and S - AI scores were performed , and the venous blood of patients was drawn to measure cortisol and Angiotension II(All) concentrations.Results(1) The data of SpO2 had no significant difference between visiting day and operation day ( P > 0. 05 ) , and so do the data among the three groups ( P > 0.05).( 2) MAP and HR in D and M groups were significantly increased on operation day as compared to MAP and HR on visiting day (P<0.01 orP<0.05) , but MAP and HR in M +X group had no significant difference (P >0.05) between visiting day and operation day . While the data had significant difference among the three groups on operation day (P<0.01 orP<0.05).( 3 ) The scores of SAS and S - AI in D and M groups were significantly increased on operation day as compared to the scores of SAS and S - AI on visiting day ( P < 0. 01 or P < 0. 05 ) , but the scores of SAS and S - AI in M + X group had no significant difference (P >0. 05) . While the data had significant difference among the three groups on operation day ( P <0. 01 or P <0. 05) .(4) The cortisol and All concentrations on operation day: Compared with the concentrations on visiting day , the concentrations in D and M groups increased significantly (P <0. 01 or P <0. 05) ,but those in M + X group had no significant difference ( P > 0. 05 ). While the concentrations had significant difference among the three groups on operation day (P<0.01 orP<0.05).DiscussionStress reaction has been defined as the individual change which is caused by stessor in biological , psychological , social and behavioral aspects. It is not the change of some local system , but the comprehensive change of all the system . It is also not only in the physiological system ,but also on the psychological behaviour aspect.We detected the patients'psychological stress reaction by the assays of multi - index analysis . We evaluated the amotional reaction by the psychological scoring scale (SAS, S - AI) , assessed the somatic reaction by the physiological index ( MAP, HR) and biochemical index ( cortisol and All concentrations in blood).The findings showed that : the manipulation of preoperative intramascular injection of midazolum 0.05mg/kg could relieve patients'anxiety ,but it couldn' t completely eliminate the patients'preoperative psychological stress reaction . The combined usage of psychological intervention and midazolum could effectively reduce patients'preoperative psychological stress reaction ,and it also greatly improved patients'emotional and somatic reaction.ConclusionThe way of combined usage of psychological intervention and midazolum is better than the single use of intramascular injection of midazolum , and it could be used for the preoperative psychological preparation of patients undergoing e-lective surgery. It is a simple and effective method to reduce patients'preoperative psychological stress reaction and relieve their anxiety.