摘要
目的分析瑞马唑仑对腹腔镜胆囊切除术病人血清丙二醛(MDA)、超氧化物歧化酶(SOD)和谷胱甘肽过氧化物酶(GSH-Px)水平的影响。方法2021年12月~2022年11月本院收治的胆囊炎、胆石症行腹腔镜胆囊切除术病人110例,按照随机数表法分成两组,丙泊酚组55例,应用丙泊酚进行麻醉诱导与麻醉维持,瑞马唑仑组55例,应用瑞马唑仑进行麻醉诱导与麻醉维持,其余麻醉方法相同。比较两组的生命体征(平均动脉压、心率)、麻醉苏醒指标(睁眼时间、定向力恢复时间、拔管时间)、氧化应激指标(MDA、SOD、GSH-Px)、认知功能(MMSE评分)以及不良反应(呼吸抑制、躁动、头晕头痛、低血压、嗜睡)。结果瑞马唑仑组插管即刻、气腹即刻、拔管即刻的平均动脉压、心率均高于丙泊酚组,两组比较差异有统计学意义(P<0.05);瑞马唑仑组睁眼时间、定向力恢复时间、拔管时间分别为(10.37±2.15)分钟、(10.83±2.41)分钟和(11.06±2.19)分钟,丙泊酚组分别为(12.44±2.78)分钟、(13.16±2.84)分钟和(14.78±2.55)分钟,两组比较差异有统计学意义(P<0.05);瑞马唑仑组术后1天的MDA水平[(19.73±2.32)mmol/L]低于丙泊酚组[(27.82±2.95)mmol/L],SOD、GSH-Px水平[(310.85±27.61)U/ml、(939.63±105.14)U]高于丙泊酚组[(275.33±24.97)U/ml、(844.73±96.30)U];瑞马唑仑组术后1天的MMSE评分[(26.89±1.00)分]高于丙泊酚组[(25.33±0.92)分],两组比较差异有统计学意义(P<0.05);瑞马唑仑组不良反应发生率为7.27%,低于丙泊酚组的21.82%,两组比较差异有统计学意义(P<0.05)。结论瑞马唑仑在腹腔镜胆囊切除术麻醉中的应用效果好,可稳定病人生命体征,提高麻醉苏醒质量,减轻氧化应激反应与认知功能损伤,不良反应少。
Objective To analyze the effect of remazolam on serum malondialdehyde(MDA),superoxide dismutase(SOD)and glutathione peroxidase(GSH Px)levels in patients undergoing laparoscopic cholecystectomy.Methods From december 2021 to november 2022,110 patients undergoing laparoscopic cholecystectomy in our general surgery department were divided into propofol group and ramazolam group according to the random number table method.55 patients in the propofol group were anesthetized with propofol for induction and maintenance,55 patients in the ramazolam group were anesthetized with ramazolam for induction and maintenance.The vital signs(mean arterial pressure,heart rate),indexes of anesthesia awakening(eye opening time,orientation recovery time,extubation time),indexes of oxidative stress(MDA,SOD,GSH Px),cognitive function(MMSE score)and adverse reactions(respiratory depression,restlessness,dizziness,headache,hypotension,drowsiness)of the two groups were compared.Results The mean arterial pressure and heart rate at the time of intubation,pneumoperitoneum and extubation in the ramazolam group were higher than those in the propofol group(P<0.05).The time of eye opening,recovery of orientation and extubation in remiazolam group[(10.37±2.15)min,(10.83±2.41)min,(11.06±2.19)min]were shorter than those in propofol group[(12.44±2.78)min,(13.16±2.84)min,(14.78±2.55)min](P<0.05).The level of MDA at 1 day after surgery in remiazolam group[(19.73±2.32)mmol/L]were lower than those in propofol group[(27.82±2.95)mmol/L],and the level of SOD and GSH Px in remiazolam group[(310.85±27.61)U/ml,(939.63±105.14)U]were higher than those in propofol group[(275.33±24.97)U/ml,(844.73±96.30)U](all P<0.05).MMSE score of remiazolam group(26.89±1.00)was higher than that of propofol group(25.33±0.92)on the first day after operation(P<0.05).The incidence of adverse reactions in remidazolam group was 7.27%,lower than 21.82%in propofol group(P<0.05).Conclusion Remazolam is effective in anesthesia of laparoscopic cholecystectomy.It can stabilize the vital signs of patients,improve the quality of recovery from anesthesia,reduce oxidative stress reaction and cognitive function damage,and has few adverse reactions.
作者
朱艺霞
王明虹
谢薇薇
徐曈
ZHU Yixia;WANG Minghong;XIE Weiwei;XU Tong(Department of Anesthesiology,NingDe Municipal Hospital of Ningde Normal University,Fujian,Ningde 352100,China)
出处
《临床外科杂志》
2023年第10期982-985,共4页
Journal of Clinical Surgery
