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Research & Application Of Psychological Dredge In Olders' Anesthesia

Posted on:2009-10-21Degree:MasterType:Thesis
Country:ChinaCandidate:Y C HuFull Text:PDF
GTID:2144360272971583Subject:Anesthesia
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Objective: As the development of the society, people's life expectancy has reached near 70, the improvement of medical treatment and public sanitation has reduced the perinatal mortality and prolonged the life expectancy. Nowadays the formation of the society is going to be ageing of population, so it has become an important topic to research the olders' Anesthesia operation.The older, the less ability people has to fit for the environment. Old stillness and change of basic parameters have not been the main factors(Such as still heart rate or Glucocorticoid hormone level), the main factor has been change of reacting ability to the environmental irritate(such as physical exercise or fasting).Face to the Anesthesia operation, patients usually show a lot of anxiety, which is related to patients' psychological issues. Such anxiety like: worry about the effectiveness of the operation; Fear pain the operation may bring; worry about the life in future; Accident in operation; worry about doctors' skill and experience. The factors mentioned above are the main factors of stress during anesthesia. Such anxiety usually come with different level of stress, adrenal medulla system is a obvious one, which can release more catecholamines in blood, heart oxygen consumption will be increased consequently. If an operation is taken under this situation, more pressure will be pushed to the heart oxygen consumption, during operation, blood vessel in brain or heart may increase unexpectly, further more, nervous may affect the blood circulation and nerve conduction, bring patient with anxiety, pain and dumps etc. So, the control of stress during anesthesia is important. More over, as the mode biological- medical is changing to biological- psychological-society medical mode, doctors is paying more and more attention to patients' psychology factors.The topic of this research will be the influence of pre-operational Psychological dredge to the stress in olders' anesthesia operation.Methods: Take random sample of 120 patients aged from 65 to 89, and classify them in two groups: experimental group and contrast group. Patients in contrast group will fill the SDS form(Self Depressing Scale), no other dredge will be placed; Patients in experimental group will be given some psychological treatment: 1, information offering, offer safety and necessity information before operation. 2, cognitive therapy: introduce method and process of Anesthesia, and matters need attention. 3, relax exercise, guide patients to do relax exercise, abdominal breathe, to decrease the nervous and improve their sleep quality.Change of hemodynamics, blood sugar, glucocorticoid density, electroencephalogram were recorded separately by the two groups, and further survey was made on two groups' restore situation.Results: MAP, SAP and DAP increased obviously during operation of patients in contrast group, while in the experimental group, there were no obvious changes of blood pressure and heart rate, and in this group the hemodynamics change was relatively stable. After 60 minutes value of blood sugar in contrast group increased obviously, while the experimental group increased quite less. The result reveals that by some pre-operational psychological dredge, we can control the stress of patients during operations, and we can reduce the blood sugar level. Electroencephalogram change during operation reveals that after 30 mins of anesthesia, more sleep the patients have in experimental group than the contrast group. It illustrates that psychological dredge can increase the enkephalin and a waves in brain electricity, and decrease the impulsion of sympathetic nerve, which can help patients remain calm.During operations, patients in experimental group performed better in calm grade than patients in contrast group, and after operation, again, in the pain grade patients in experimental group performed better. This reveals that effective psychological dredge can decrease patients' anxiety and pains, which can also decrease effectiveness of analgesics.Besides, we survey and evaluate 120 patients' cortisol density in blood at 8 o'clockboth before and on the day of operations(experimental groups 60 and contrastgroup 60), the result revealed that patients in contrast group, their cortisol densityin blood on the day of operation was obvious higher than the day before, while thesame figure was much lower in the experimental group. Psychological leading canimprove patients' sentiment, reduce cortisol level, in order to reduce the stresshormone level.Conclusion: By Psychological dredge in olders' anesthesia, stress can bedecreased obviously, and by this patients can restore sooner.
Keywords/Search Tags:Psychology, stress, anesthesia, older
PDF Full Text Request
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