右美托咪定、咪达唑仑对择期手术病人认知功能的影响

Influence of dexmedetomidine and midazolam on cognitive function of patients undergoing elective surgery

目的探讨右美托咪定、咪达唑仑对择期手术病人认知功能的影响。方法选取行择期手术的区域麻醉病人90例,按数字均分法随机分成右美托咪定组、咪达唑仑组及对照组,每组30例。三组病人于麻醉前20 min分别给予静脉泵注右美托咪定、静注咪达唑仑和静注生理盐水。观察三组病人用药前后焦虑视觉模拟/焦虑状态问卷评分、警觉/镇静评分;比较术后24 h对水果图片的记忆情况。结果组内用药前后比较,对照组用药后10 min脑电双频谱指数为(92.5±1.6),焦虑视觉模拟/焦虑问卷评分为(1.8±0.3)分,警觉/镇静评分为(4.9±0.1)分;右美托咪定组用药后10 min脑电双频谱指数为(86.1±2.4),焦虑视觉模拟/焦虑问卷评分为(0.2±0.4)分,警觉/镇静评分为(2.5±0.7);咪达唑仑组用药后10 min脑电双频谱指数为(87.3±1.3),焦虑视觉模拟/焦虑问卷评分为(0.4±0.6)分,警觉/镇静评分为(2.6±1.0)分;与对照组比较,右美托咪定组与咪达唑仑组病人用药后10 min脑电双频谱指数、焦虑视觉模拟/焦虑问卷评分、警觉/镇静评分较低(P<0.05)。与咪达唑仑组相比,右美托咪定组用药后记忆正确率较高(P<0.05)。结论右美托咪定及咪达唑仑可明显改善病人麻醉前紧张焦虑情绪,提高记忆力,右美托咪定对病人的短期记忆功能影响小。

Objective To explore the influence of dexmedetomidine and midazolam on cognitive function of patients undergoing elective surgery.Method 90 patients undergoing elective surgery in our hospital were randomly divided into dexmedetomidine group,midazolam group and control group and every group had 30 patients.Patients in 3 groups were administered 20 minutes before anesthesia.Patients in dexmedetomidine group were given intravenous infusion of dexmedetomidine,patients in midazolam group were given intravenous injection of midazolam and patients in control group were given intravenous injection of saline.To comparison the 3 groups of patients after 1 days of medication before and after medication on memory and fruit picture anxiety visual analog/anxiety questionnaire score,alertness/sedation score.Results Compared to patients before treatment,the bispectral index of 10 min in the control group was （92.5±1.6）,anxiety visual analog anxiety questionnaire score was （1.8±0.3）,alertness/sedation score was（4.9±0.1）.The bispectral index of 10 min in the dexmedetomidine group was （86.1±2.4）,anxiety visual analog anxiety questionnaire score was （0.2±0.4）,alertness/sedation score was（2.5±0.7）.The bispectral index of 10 min in the midazolam group was （87.3±1.3）,anxiety visual analog anxiety questionnaire score was （0.4±0.6）,alertness/sedation score was （2.6±1.0）.Compared to control group,patients in dexmedetomidine group and midazolam group had lower bispectral index,anxiety/anxiety questionnaire,visual analogue score alertness/sedation score after 10 minutes （P〈0.05）.Compared to midazolam group,patients in dexmedetomidine group and control group had higher correct rate of memory （P〈0.05）.Conclusions Dexmedetomidine and midazolam can significantly improve the anxiety before anesthesia,improve memory,dexmedetomidine on short-term memory function in patients with small.