咪达唑仑抗焦虑治疗对择期腰椎手术患者术中麻醉药用量及术后恢复的影响

Effect of midazolam on the dosage of anesthesia drugs and postoperative recovery in selective lumbar surgery

目的探讨术前咪达唑仑抗焦虑治疗对择期腰椎手术患者手术过程中麻醉药用量及术后恢复的影响。方法 60例符合入选标准的择期腰椎手术患者随机分为对照组(n=30)和观察组(n=30)。对照组给予丙泊酚麻醉诱导,观察组麻醉诱导前40min给予咪达唑仑,再给予丙泊酚麻醉诱导。观察比较两组患者术中丙泊酚用量、术后疼痛评分及MMSE评分。结果观察组术中丙泊酚总用量为(492.6±98.7)mg,明显低于对照组(760.4±107.5)mg的总用量(P<0.05)。与对照组相比,观察组术后2h、4h的VAS疼痛评分显著降低,比较都有统计学差异(P均<0.05),而术后6h、12h、24h的VAS疼痛评分组间比较无统计学差异(P均>0.05)。术后,观察组反映认知功能的MMSE评分为(25.6±6.1)分,与对照组(25.3±5.9)分比较无统计学差异(P>0.05)。结论咪达唑仑术前抗焦虑治疗可以减少择期腰椎手术术中麻醉药用量,并增强术后镇痛效果,且不增加术后认知功能损害,临床上值得进一步研究。

Objective To investigate the effect of midazolam on the dosage of anesthesia drugs and postoperative recovery in selective lumbar surgery. Methods60 cases of selective lumbar surgery meeting the inclusion critera were randomly divided into 2 groups equally. The control group was anaesthetized with propofol, while the observation group was given midazolam before anaesthesia with propofol. Then, the total dosage of propofol during the surgery, pain score after the surgery and occurrence of postoperative cognitive dysfunction were observed and compared.Results The total dosage of propofol in the observation was （492.6±98.7） mg, which was statistically lower than that of （760.4±107.5） mg in the control group （P〈0.05）. Compared with the control group, pain score of 2h, 4h after the surgery was statistically lower in the observation group （both P〈0.05）, while pain score of 6h, 12h, 24h after the surgery were statistically same in the two groups （allP〉0.05）.MMSE score in the observation group after surgery was （25.6±6.1） points, which was statistically same with that of （25.3±5.9） points in the control group （P〉0.05）.Conclusion Midazolam could reduce dosage of anesthesia drugs in selective lumbar surgery, promote analgesic effect after surgery with no effect of increasing postoperative cognitive dysfuntion.