Assessment of hemodynamic parameters, early cognitive functions and anxiety state in patients who underwent orthopedic prosthesis operation under spinal anesthesia and were and were not infused midazolam

Regional anesthesia is a commonly preferred method for patients who are undergoing orthopedic surgery. Patient is conscious during regional anesthesia. Most patients prefer absolute anesthesia during surgery in order to decrease anxiety. In order to avoid this disadvantage of regional anesthesia, sedation is induced with various agents throughout the surgical procedure. Aim of this study is to assess the efficiency of continuous infusion of midazolam, which ensures a sedation level corresponding sedation score of 2 on the Ramsey sedation scale, on eliminating perioperative anxiety in patients, who will undergo orthopedic operation under spinal anesthesia, in comparison with the control group and to evaluate effects on early cognitive functions and hemodynamic parameters. This study enrolled 60 ASA Class I and II patients. Patients were randomized into two groups. Patients were assessed with State Trait Inventory (STAI) and Mini Mental Test in preoperative anesthesia preparation room. Spinal anesthesia was induced with 0.5% hyperbaric bupivacaine 2.5 ml in both groups. SBP, DBP, MBP, HR, Respiration Rate, SaO2 and Ramsey sedation were recorded before spinal block (BB), after block (AB) and at 1, 5, 10, 15, 20, 30, 45, 60 and 75 minutes after sedative was administered and at the end of the operation. Patients were postoperatively transferred to the recovery room and they assessed with State Trait Inventory (STAI) and Mini Mental Test at 15 and 60 minutes. Side effects were recorded. In conclusion, it was demonstrated that continuous infusion of midazolam achieved controlled sedation with minimal side effect and significantly reduced perioperative anxiety in patients, who undergo orthopedic operation under spinal anesthesia, in comparison with the control group. This sedation method was considered as satisfactory by patients and surgeons. Intraoperative hemodynamic stability of both groups was close to the normal range and postoperative cognitive functions were almost similar with preoperative cognitive functions.