The control effect of monitored anesthesia care on stress reaction of operation under local anesthesia

Objective To observe and compare the control effect of monitored anesthesia care on stress reaction of operation under local anesthesia. Methods Fourty-five patients who undered ophthalmology and otolaryngology operation and ASAⅠorⅡclass, aged 20-55 years were enrolled. They were randomly divided into 3 groups: monitored anesthesia care(M group), general anesthesia (G group), and local anesthesia (L group). All of three groups were performed local nerve block anesthesia. Mean arterial blood pressure (MAP)、heart rate (HR) were recorded at enter room (T1), the strongest operation stimulation (T2), the end of operation (T3). At the same time,the levels of blood glucose,plasma cortisol (Cor) were assayed. The scores of state of anxiety (S-AI) before operation and after operation in two groups were compared. Results The levels of MAP and Cor at T2, T3 and HR at T2 in G group and M group were significantly lower than those at T1: (68.1±8.2), (78.8±12.8) mmHg (1 mmHg=0.133 kPa) vs. (95.7±11.3) mmHg; (80.8±11.7), (86.2±9.0) mmHg vs. (94.7±11.5) mmHg; (207.0±71.8), (135.2±60.9) nmol/L vs. (336.7±121.4) nmol/L; (220.8±113.2),(190.4±149.0) nmol/L vs. (347.8±154.6) nmol/L; (68.1±10.6) beats/min vs. (79.9±14.2) beats/min; (70.3±10.1) beats/min vs. (80.6±12.2) beats/min, there were significant differences (P<0.05). The level of blood glucose at T3 was significantly lower than that at T1 in G group [ (4.9±0.7) mmol/L vs. (5.5±0.6) mmol/L], there was significant difference (P<0.05) . The levels of MAP, Cor at T2 in G group and M group, at T3 in G group were significantly lower than those at the same point in L group: [ (68.1±8.2) , (80.8±11.7) mmHg vs. (93.4±12.5) mmHg, (207.0±71.8) , (220.8±113.2) nmol/L vs. (367.1±157.3) nmol/L, (78.8±12.8) mmHg vs. (92.6±15.3) mmHg, (135.2±60.7) nmol/L vs. (311.9±165.6) nmol/L], there were significant differences (P<0.05) . The scores of S-AI at postoperative in G group and L group were significantly lower than that at preoperative: (31.5±6.6) scores vs. (44.3±15.0) scores, (35.2±11.5) scores vs. (49.3±14.2) scores, there were significant differences (P<0.05). Conclusion Monitored anesthesia care can alleviate stress reaction in operation with local anesthesia,while its effect is similar with general nesthesia. Key words: Anesthesia, general; Intraoperative period; Stress reaction