摘要
目的研究瑞马唑仑与咪达唑仑对全身麻醉下行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)患者术后认知功能的影响。方法选择160例全身麻醉下行LC患者,按随机数字表法分为观察组和对照组各80例。观察组术中麻醉诱导时静脉注射瑞马唑仑0.30 mg/kg、舒芬太尼0.50μg/kg、罗库溴铵0.60 mg/kg;对照组术中麻醉诱导时应用咪达唑仑0.05 mg/kg、舒芬太尼0.50μg/kg、罗库溴铵0.60 mg/kg。记录2组患者手术麻醉诱导时(T0)、脑电双频指数值<60时(T1)、插管后(T2)平均动脉压(mean artery pressure,MAP)、心率(heart rate,HR)变化;术后睁眼时间、拔管时间、麻醉后监测治疗室(postanesthesia care unit,PACU)停留时间;手术前、术后24 h和72 h简易精神状态评价量表(mini-mental state examination,MMSE)得分水平;术后不良反应发生情况。结果2组MAP呈先降低后升高趋势,观察组MAP变化幅度小于对照组,2组HR呈逐渐升高趋势,观察组HR低于对照组,组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05)。观察组患者睁眼时间、拔管时间、PACU停留时间明显短于对照组,差异有统计学意义(P<0.05)。2组MMSE得分呈先降低后升高趋势,观察组MMSE得分变化幅度小于对照组,组间、时点间、组间·时点间交互作用差异均有统计学意义(P<0.05)。观察组低血压发生率低于对照组,差异有统计学意义(P<0.05),2组患者呼吸抑制、躁动、头晕头痛和嗜睡发生率差异无统计学意义(P>0.05)。结论与咪达唑仑相比,瑞马唑仑应用于LC术安全性较好、认知功能影响较小、麻醉恢复较快,不良反应发生较少。
Objective To study the effect of remazolam and midazolam on postoperative cognitive function of patients undergoing laparoscopic cholecystectomy(LC)under general anesthesia.Methods A total of 160 patients undergoing LC under general anesthesia were divided into observation group(n=80)and control group(n=80)according to random number table method.In the observation group,0.30 mg/kg remazzolam,0.50μg/kg sufentanil and 0.60 mg/kg rocuronium were injected intravenously during anesthesia induction.In the control group,0.05 mg/kg midazolam,0.50μg/kg sufentanil and 0.60 mg/kg rocuronium were used during anesthesia induction.The changes of mean arterial pressure(MAP)and heart rate(HR)were recorded at anesthesia induction(T0),bispectral index<60(T1)and after intubation(T2).Eye opening time,extubation time and duration of postanesthesia care unit(PACU)stay after anesthesia,score level of mini-mental state examination(MMSE)before operation,at 24 h and 72 h after operation,and incidence of postoperative adverse reactions were recorded.Results The MAP of the two groups was decreased first and then increased,while the change range of MAP in the observation group was smaller than that in the control group,while HR in the observation group was increased gradually.There were significant differences in interaction between groups,time points and time points between groups(P<0.05).The eye opening time,extubation time and duration of PACU stay of patients in the observation group were significantly shorter than those in the control group,suggesting significant difference(P<0.05).The MMSE scores of the two groups were decreased initially and then increased.The change range of MMSE scores of the observation group was smaller than that of the control group,and there were significant differences in interaction between groups,time points and time points between groups(P<0.05).The incidence of hypotension in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was n
作者
钱焕丽
李元海
何川
QIAN Huan-li;LI Yuan-hai;HE Chuan(Department of Anesthesiology, People′s Hospital of Bozhou, Anhui Province, Bozhou 236800, China;Department of Anesthesiology, the First Affiliated Hospital of Anhui Medical University, Hefei 230000, China)
出处
《河北医科大学学报》
CAS
2021年第6期704-707,712,共5页
Journal of Hebei Medical University
基金
安徽省公益性技术应用研究联动计划项目(1704f0804021)。
