| Objective: By assessing the level of anxiety of elderly patients before surgery,to observe whether music intervention can relieve the anxiety of elderly patients during surgery and play a sedative role,and whether it can reduce the effect of perioperative anxiety on patients’ hemodynamics as a non-drug intervention method.Methods: This study recruited 111 patients of ASA Grade fromⅠto Ⅲ,aged more than60 years and scheduled for the transurethral resection of prostate(TURP)under spinal anesthesia at People’s Hospital of Liaoning Province between June 2021 and March2022.According to the exclusion criteria,82 patients were eventually included and randomly assigned to the music group and the control group,containing 41 patients in each group.The whole patients received the operation and care of the same surgical team in the operation room,and the same anesthesiologist provided anesthesia operation and management.Patients in both groups wore a pair of non-noiseless headset Bluetooth headphones.Patients in the music group listened to the music "Ocean Blue" that was selected in this study after entering in the operating room until leaving the room.And the music was adjusted to the right volume by the patient.Patients in the control group wore the same headphones without music.The montreal cognitive assessment(Mo CA)was used for cognitive assessment of the enrolled patients at the day before surgery.The anxiety-visual analogue scale(A-VAS)and the Amsterdam preoperative anxiety and information scale(APAIS)were used for preoperative anxiety assessment.After entering in the operation room,venous access was established,vital signs were monitored and BIS(bispectral Index)was monitored.Mo CA score,A-VAS score and satisfaction score were collected at the day after surgery.The main outcome of this study was BIS,secondary outcomes included A-VAS,systolic blood pressure(SBP),diastolic blood pressure(DBP),mean arterial pressure(MAP),heart rate(HR),and satisfaction score,and so on.The observation time points were as follow: T0(after entering in operation room),T1(5 minutes after entry),T2(immediately after completion of anesthesia),T3(5 minutes after anesthesia),T4(immediately after change of lithotomy position),T5(5 minutes after change of lithotomy position),T6(the start of operation),T7～T12(5 minutes,10 minutes,15 minutes,30 minutes,45 minutes and 60 minutes after starting),T13(at the end of the operation),T14(after changing to supine position),and T15(before leaving the room).Result: Age,ASA grade,height,weight,BMI,the puncture interspace,operation duration,preoperative Mo CA score,preoperative A-VAS score and APAIS score were compared between the music group and the control group,and there was no significant difference(P>0.05).The comparison between the music group and the control group showed that BIS values of T1～T13 in the music group were significantly lower than those in the control group(P<0.001),and the SBP values of the music group at T6 and T12 were significantly lower than those of the control group(P<0.05),and postoperative satisfaction score of the music group was not significantly higher than that of the control group(P>0.05).Within the music group,the comparison between the T1～T15 time points and the T0 time point showed that: BIS values were significantly lower at the T1～T13 time points(P<0.05),and SBP values were significantly lower at the T1～T15 time points(P<0.05),and DBP values were significantly lower at the T1～T15 time points(P<0.05),and MAP values were significantly lower at the T3 and T1～T15 time points(P<0.05),and HR values were significantly lower at the T1～T15time points(P<0.05).Within the control group,the comparison between the T1～T15time points and the T0 time point showed that: BIS values were significantly lower at the T1,T3 and T5～T13 time points(P<0.05),and SBP values were significantly lower at the T1～T15 time points(P<0.05),and DBP values were significantly lower at the T1,T6～T12 and T14 time points(P<0.05),and MAP values were significantly lower at the T2～ T15 time points(P<0.05),and HR values were significantly lower at the T1 and T5～T 15 time points(P<0.05).A-VAS scores showed that the scores of patients in both the music group and the control group significantly increased at the time of entering in the operation room than the day before surgery(P<0.05),and the scores of the day after surgery significantly decreased than the day before surgery(P<0.05).Conclusion: This study showed that music intervention had a sedative effect on patients undergoing spinal anesthesia during TURP.During anesthesia operation,position change and operation,the hemodynamic parameters kept stable,so as to improve the quality of anesthesia.Music intervention was a perioperative sedation auxiliary technique worth popularizing in clinical practice. |
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