摘要
目的探讨苯磺酸瑞马唑仑与咪达唑仑对全身麻醉下行妇科腹腔镜手术患者术后认知功能的影响。方法选取2019年5月至2021年1月海口市妇幼保健院120例全身麻醉下行妇科腹腔镜手术的患者,采用随机数字表法分为对照组(60例)、观察组(60例)两组。对照组给予咪达唑仑0.05 mg/kg、舒芬太尼0.50μg/kg、维库溴铵0.15 mg/kg进行麻醉诱导,观察组患者给予苯磺酸瑞马唑仑0.3 mg/kg、舒芬太尼0.50μg/kg、维库溴铵0.15 mg/kg进行麻醉诱导。对比两组麻醉前(T0)、麻醉时(T1)、插管后(T2)时血流动力学各指标水平以及术后麻醉恢复指标水平,记录对比术前、术后24 h、术后72 h视觉模拟疼痛评分(VAS)和简易精神状态评价量表(MMSE)评分,并记录比较两组术后不良反应总发生率。结果两组T1、T2时HR高于T0时,T1、T2时SpO2低于T0时,T1时MAP低于T0时,T2时MAP高于T0时,差异均有统计学意义(均P<0.05);观察组T1、T2时HR、MAP低于对照组,SpO2高于对照组(均P<0.05)。观察组术后自主呼吸恢复时间、睁眼时间、拔管时间显著短于对照组(均P<0.05)。两组术后24 h、72 h MMSE评分低于术前,24 h VAS评分高于术前(均P<0.05);观察组术后24 h、72 h MMSE评分显著高于对照组(P<0.05),两组术后24 h、72 h VAS评分差异无统计学意义(均P>0.05);两组不良反应总发生率差异无统计学意义(P>0.05)。结论苯磺酸瑞马唑仑对全身麻醉下行妇科腹腔镜手术患者的认知功能影响较小,恢复快,安全性高,值得临床推广。
Objective To investigate the effects of remimazolam besylate and midazolam on postoperative cognitive function of patients undergoing gynecologic laparoscopic surgery under general anesthesia.Methods From May 2019 to January 2021,120 patients with gynecological laparoscopic surgery under general anesthesia in Haikou Maternal and Child Health Hospital were selected and divided into control group(60 cases)and observation group(60 cases)by random number table.The control group was given 0.05 mg/kg midazolam and 0.50μg/kg sufentanil and 0.15 mg/kg vecuronium bromide were used for anesthesia induction.Patients in the observation group were given 0.3 mg/kg remimazolam besylate and 0.50μg/kg sufentanil and 0.15 mg/kg vecuronium were used for anesthesia induction.The levels of hemodynamic indexes before anesthesia(T0),during anesthesia(T1),and after intubation(T2)as well as the levels of postoperative anesthesia recovery indexes were compared between the two groups.The Visual Analogue Scale(VAS)score and Mini-Mental State Examination(MMSE)scores were recorded and compared before surgery,24 h,72 h after surgery.The total incidence of adverse reactions after surgery was recorded and compared between the two groups.Results The heart rate(HR)at T1 and T2 in the two groups was higher than that at T0,the oxygen saturation(SpO2)at T1 and T2 was lower than that at T0,the mean arterial pressure(MAP)at T1 was lower than that at T0,and the MAP at T2 was higher than that at T0,with statistically significant difference(all P<0.05);The HR and MAP at T1 and T2 in the observation group were lower than those in the control group,and SpO2 was higher than those in the control group(all P<0.05);The recovery time of spontaneous respiration,eye opening time and extubation time in the observation group were significantly shorter than those in the control group(all P<0.05);The MMSE score at 24 h and 72 h after operation was lower than that before operation,and the VAS score at 24 h was higher than that before operation in both groups(all P<0.05);The MMSE scores in the observation group at 24 h and 72 h after operation were significantly higher than those in the control group(all P<0.05),and there was no significant difference in the VAS scores at 24 h and 72 h after operation between the two groups(P>0.05);There was no significant difference in the total incidence of adverse reactions between the two groups(all P>0.05).Conclusions Remimazolam besylate has little effect on cognitive function of patients undergoing gynecologic laparoscopic surgery under general anesthesia,with fast recovery and high safety,which is worthy of clinical promotion.
作者
纪星星
黄婷婉
李双凤
Ji Xingxing;Huang Tingwan;Li Shuangfeng(Department of Anesthesiology,Haikou Maternal and Child Health Hospital,Haikou 571100,China)
出处
《中国医师杂志》
CAS
2023年第1期33-36,42,共5页
Journal of Chinese Physician
基金
海南省自然科学基金(820QN393)。
关键词
咪达唑仑
瑞马唑仑
腹腔镜检查
妇科外科手术
麻醉
全身
认知
Midazolam
Remimazolam
Laparoscopy
Gynecologic surgical procedures
Anesthesia,general
Cognition
作者简介
通信作者:纪星星,Email:2563050915@qq.com。
