对比分析咪达唑仑与瑞马唑仑对全身麻醉下行腹腔镜胆囊切除术患者的效果及对术后认知功能的影响.pdf
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1、SYSTEMS MEDICINE 系统医学系统医学 2023 年 7 月第 8 卷第 14 期 内科研究 对比分析咪达唑仑与瑞马唑仑对全身麻醉下行腹腔镜胆囊切除术患者的效果及对术后认知功能的影响陈虹烨,张鑫磊,佟飞,孔明健徐州矿务集团总医院麻醉科,江苏徐州 221006摘要 目的 对比分析咪达唑仑与瑞马唑仑对全身麻醉下行腹腔镜胆囊切除术患者的效果及对术后认知功能的影响。方法 选取 2022年 3月2023年 5月徐州矿务集团总医院收治的全身麻醉下行腹腔镜胆囊切除术的患者92例为研究对象,根据随机数表法分为两组,各46例。对照组麻醉诱导时静脉注射0.05 mg/kg咪达唑仑、0.50 g/kg舒
2、芬太尼、0.60 mg/kg罗库溴铵;观察组麻醉诱导时静脉注射0.30 mg/kg瑞马唑仑、0.50 g/kg舒芬太尼、0.60 mg/kg罗库溴铵。对比两组患者术后睁眼时间、拔管时间、麻醉复苏室停留时间,手术前后应激指标、认知功能及术后不良反应。结果 观察组术后睁眼、拔管及麻醉复苏室停留时间均短于对照组,差异有统计学意义(P0.05)。术后,观察组胰岛素、皮质醇水平均低于对照组,差异有统计学意义(P0.05)。术后24、72 h,观察组简易智力状态检查量表评分均高于对照组,差异有统计学意义(P0.05)。观察组患者呼吸抑制、低血压、嗜睡、恶心呕吐等的不良反应发生率为 10.87%,低于对照组
3、的 28.26%,差异有统计学意义(2=4.420,P0.05)。结论 采取瑞马唑仑对全身麻醉下行腹腔镜胆囊切除术患者进行麻醉可以加速患者术后麻醉恢复,麻醉效果较好,还可降低机体应激反应,较快恢复术后认知功能,且安全性较高。关键词 咪达唑仑;瑞马唑仑;全身麻醉;腹腔镜胆囊切除术;应激反应;术后认知功能中图分类号 R657 文献标识码 A 文章编号 2096-1782(2023)07(b)-0097-04Comparative Analysis of the Effects of Midazolam and Remimazolam on Patients Undergoing Laparosco
4、pic Cholecystectomy under General Anesthesia and Their Impact on Postoperative Cognitive FunctionCHEN Hongye,ZHANG Xinlei,TONG Fei,KONG MingjianDepartment of Anesthesiology,Xuzhou Mining Group General Hospital,Xuzhou,Jiangsu Province,221006 ChinaAbstract Objective To comparatively analyze the effect
5、s of midazolam and remimazolam on patients undergoing laparoscopic cholecystectomy under general anesthesia and their impact on postoperative cognitive function.Methods 92 patients undergoing laparoscopic cholecystectomy under general anesthesia admitted to Xuzhou Mining Group General Hospital from
6、March 2022 to May 2023 were selected as the study subjects.They were divided into two groups using a random number table method,with 46 patients in each group.Intravenous injection of 0.05 mg/kg midazolam and 0.50 g/kg sufentanil and 0.60 mg/kg rocuronium during anesthesia induction in the control g
7、roup;Observation group received intravenous injection of 0.30 mg/kg remimazolam and 0.50 g/kg sufentanil and 0.60 mg/kg rocuronium during anesthesia induction.Compared the postoperative eye opening time,extubation time,anesthesia resuscitation room stay time,preoperative and postoperative stress ind
8、icators,cognitive function,and postoperative adverse reactions between two groups of patients.Results The observation group had shorter postoperative eye opening,extubation,and anesthesia resuscitation room stay times than the control group,the difference was statistically significant(P0.05).After s
9、urgery,the levels of INS and Cor in the observation group were lower than those in the control group,the difference was statistically significant(P0.05).At 24 and 72 hours after surgery,the MMSE scores in the DOI:10.19368/ki.2096-1782.2023.14.097作者简介 陈虹烨(1985-),女,本科,副主任医师,研究方向为临床麻醉。通信作者 孔明健(1975-),女
10、,博士,主任医师,研究方向为临床麻醉,E-mail:。97系统医学 2023 年 7 月第 8 卷第 14 期 内科研究 系统医学 SYSTEMS MEDICINEobservation group were higher than those in the control group,the difference was statistically significant(P0.05).The incidence of adverse reactions such as respiratory depression,hypotension,drowsiness,nausea and vomi
11、ting in the observation group 10.87%was lower than that in the control group,which was 28.26%,and the difference was statistically significant(2=4.420,P0.05),具有可比性。本研究经本院医学伦理委员会批准。1.2 纳入与排除标准纳入标准:符合手术指征,进行腹腔镜胆囊切除手术患者;对研究使用的药物无禁忌患者;近半年未使用过镇痛或镇静类药物患者;患者及家属知情同意本研究。排除标准:凝血功能异常患者;严重器质性疾病患者;具有心动过缓或精神类疾病患者
12、;认知功能障碍患者。1.3 方法对照组:麻醉诱导:静脉注射咪达唑仑(国药准字 H10980025;规格:2 mL10 mg)0.05 mg/kg、舒芬太尼注射液(国药准字 H20054171;规格:1 mL50 g)0.50 g/kg、罗 库 溴 铵 注 射 液(国 药 准 字H20213778;规格:5 mL50 mg)0.60 mg/kg;插管期间,给予患者间歇性正压机械通气。麻醉维持:静脉输注丙泊酚(国药准字 H20123318;规格:50 mL1 g)412 mg/(kgh),注射用盐酸瑞芬太尼(国药准字 H20030197;规格:1 mg)0.050.2 mg/(kgh)。手术完成后
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