咪达唑仑与右美托咪定对腹腔镜胆囊切除术的麻醉效果对比

Comparison of the anesthetic effects of midazolam and dexmedetomidine in laparoscopic cholecystectomy

目的比较咪达唑仑与右美托咪定对腹腔镜胆囊切除术的麻醉效果。方法选取2017年10月至2019年2月来本院择期行腹腔镜胆囊切除术的患者90例,将其随机分为两组,各45例。麻醉诱导前观察组给予右美托咪定,对照组给予咪达唑仑。两组患者手术的一般情况,不同时点的心率和血压的变化情况,不同时点患者的认知能力进行分析。结果观察组自主呼吸恢复时间、苏醒时间、拔管时间分别为(7.2±1.5)min、(8.3±1.5)min、(7.9±1.8)min,均低于对照组,差异均有统计学意义(均P<0.05);两组患者不同时点的心率、SBP、DBP比较,差异均有统计学意义(均P<0.05);组内不同时点间患者的心率、SBP、DBP比较,差异均有统计学意义(均P<0.05);组间与时间交互作用比较,差异均无统计学意义(均P>0.05);麻醉前,两组患者认知能力评分比较,差异无统计学意义(P>0.05);麻醉后1 d、3 d,观察组认知能力评分均高于对照组,差异均有统计学意义(均P<0.05)。结论在腹腔镜胆囊切除术中,采用右美托咪定的麻醉效果优于咪达唑仑,其安全性更好,心血管应激反应更小,具有更高的临床应用价值。

Objective To compare the anesthetic effects of midazolam and dexmedetomidine in laparoscopic cholecystectomy.Methods 90 patients who underwent elective laparoscopic cholecystectomy in our hospital from October 2017 to February 2019 were collected,then were randomly divided into observation group(45 cases)and control group(45 cases).The patients in the observation group were given dexmedetomidine before anesthesia induction,while the patients in the control group were given midazolam.The general situation of operation,the changes of heart rate and blood pressure at different time points,and the cognitive ability scores of patients at different time points were compared between the two groups.Results The recovery time of spontaneous breathing[(7.2±1.5)min],recovery time[(8.3±1.5)min],and extubation time[(7.9±1.8)min]in the observation group were shorter than those in the control group,with statistically significant differences(P<0.05).There were statistically significant differences in heart rate,SBP,and DBP between the observation group and the control group at different time points(P<0.05),there were statistically significant differences in heart rate,SBP,and DBP among different time points in each group(P<0.05),there were no interaction between heart rate,SBP,DBP and time in the two groups(P>0.05).There was no statistically significant difference in cognitive ability between the two groups before anesthesia(P>0.05);there were statistically significant differences in cognitive ability score between the two groups at 1 d,3 d after anesthesia(P<0.05).Conclusion In laparoscopic cholecystectomy,the anesthetic effect of dexmedetomidine is better than that of midazolam,and it is much safer,with less cardiovascular stress response and higher clinical application value.