The effects of midazolam on the hemodynamic, early cognitive functions and anxiety in hypertension versus non hypertension patient under spinal anaesthesia during urologic surgery

Regional anesthesia is one of the commonly used anaesthetic method in urological operations. The patients are awake during regional anesthesia. Most of the patients want to be sedatized during surgery to decrease their anxiety. To prevent this disadvantage of regional anaesthesia, some sedative medication apply to patients during surgery. The purpose of this study is to eveluate effect of using continuous infusion midazolom providing required sedation levels according to Ramsey sedation scale to decrease preoperative anxiety in patients undergoing urological surgery with and without hypertension under spinal anesthesia and effects on hemodynamic parametres and early cognitive functions.This study was performed on 70 patient from ASA 1-3 class. The patients were divided randomly into 2 groups with and without hypertension. Patients were eveluated with State Trait Anxiety Inventory and Mini Mental State Examination in the preoperative anesthesia prepare room. Spinal anesthesia was performed with 2,5 ml % 0,5 hiperbarik bupivakain both groups. Prespinal block, postspinal bloc and sedation after 1th., 5th., 10th, 15th, 20th, 30th, 45th, 60th, 75th. minutes and postoperative SAP, DAP, MAP, HR, RR, SaO2 and Ramsey sedasyon score were reported. Patients were taken to recovery room postoperative and eveluated with STAI and Mini Mental State Examination at the postoperative 15th and 60th minutes. Side effects were reported.In conclusion, continuous infusion midazolom to decrease preoperative anxiety in the patients undergoing urologic surgery with and without hypertension under spinal anesthesia provide controlled sedation with minimal side effect and reduce preoperative anxiety. This sedation method was satisfactory by patients and surgeon and didn?t effect cognitive function in postoperative 60th minutes. There was no different on anxiety level between patients with and without hypertension. Regarding to cognitive functions of the patients with hypertension, their MMSE?s was reduced than normotension patient in preoperative and early postoperative period. In both group postoperative cognitive function was similar to preoperative cognitive function.