Preoperative Anxiety and Information Requirement in Koreans: The Contributing Factors of Anxiety and the Effect of Midazolam as an Anxiolytic Premedication / 대한마취과학회지

BACKGROUND: The objectives of the present investigation were to assess the level and contributing factors of Korean patients' anxiety and information requirement in the preoperative phase, and in addition, to confirm the efficacy of intramuscular midazolam as a routine anxiolytic premedication. METHODS: The informed patients were randomized to receive either a placebo (n = 155) or 0.05 mg/kg I.M. midazolam (n = 92) 1 hour prior to arriving at the operating room. All patients were asked by the anesthesiologist to complete a six-item questionaire, APAIS (Amsterdam Preoperative Anxiety and Information Scale) at a preoperative holding area. RESULTS: Female and cancer patients may serve as useful predictors of patients at risk for preoperative anxiety. There is a positive relationship between anxiety and information requirement. The patients who had taken 0.05 mg/kg midazolam I.M. as a premedication showed lower anxiety scores than the control group. CONCLUSIONS: In addition to performing careful in-depth assessments of anxiety and identifying coping behaviors, anesthesiologists should try to find more appropriate methods of comprehensive preoperative care.

The Incidence of Hypoxia Following the Use of Hypnotics and Analgesics during Spinal Anesthesia / 대한마취과학회지

BACKGROUND: The purpose of this study was to find out the effect of hypnotics and analgesics on oxygen saturation by pulse oximetry in surgery patients under spinal anesthesia. METHODS: Sixty-five patients classified ASA physical status 1 or 2 scheduled for surgery under spinal anesthesia were studied. These patients were divided into three groups. The 22 subjects of the first group did not receive either midazolam or fentanyl. The 22 subjects of the second group received midazolam. The 21 subjects of the third group received midazolam (0.03 mg/kg) and fentanyl (1.0 microgram/ kg). Oxygen saturation was measured with a pulse oximetry. Measurements were made before spinal anesthesia, 5 minutes, and 10 minutes after starting of spinal anesthesia, 5 minutes, 10 minutes, 30 minutes, and 60 minutes after the start of the operation or intravenous injection of drugs. In addition, measurements were made on arrival in the recovery room, and 5 minutes, 10 minutes, 20 minutes, and 30 minutes after arrival in the recovery room. RESULTS: There were statistically significant differences in oxygen saturation at 5 minutes after the start of the operation or intravenous injection of drugs. The mean oxygen saturation for the first group was 98.2 +/- 1.8%, for the second group 97.9 +/- 2.6%, and for the third group 92.4 +/- 2.8%. Hypoxia cases at 5 minutes after the start of the operation or intravenous injection of a drug occurred in 4.5% of the first group, 9.1% of the second group, and 57.1% of the third group CONCLUSIONS: We concluded that oxygen saturation monitoring should be done routinely in patients receiving hypnotics and analgesics during spinal anesthesia, and oxygen should be administered to patients who develope hypoxia during spinal anesthesia.