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| Influence of remimazolam mesylate anesthesia during laparoscopic hysterectomy of patients on their inflammatory stress response and cognitive function |
| 1.Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, Sichuan Province, 610031; 2.Jinniu Maternal and Child Health Care Hospital, Chengdu |
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Abstract To explore the influence of remimazolam mesylate anesthesia during laparoscopic hysterectomy of patients on their inflammatory stress response and cognitive function. Methods: 85 patients who wanted laparoscopic hysterectomy were enrolled and were randomly divided into observation group (46 patients with remimazolam mesylate anesthesia) and control group (39 patients with propofol anesthesia) by the envelope random method from August 2021 to January 2023. The values of hemodynamic indicators, such as heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) before anesthesia (T0), at 5 min after anesthesia (T1), at 10 min after tracheal intubation (T2), immediately after extubation (T3) and at 5 min before the end of surgery (T4), the levels of inflammatory stress indicators, such as interleukin (IL-6), C-reactive protein (CRP), tumor necrosis factor (TNF-α) and norepinephrine (NE), the scores of cognitive ability by Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) at 1 h before surgery and at 12 h after surgery, and the incidence rate of the postoperative adverse reactions of the patients were compared between two groups. Results: The HR values of the patients in the
observation group at T3 (86.6±7.4 times /min) and at T4 (78.6±6.2 times /min) were significantly lower than those (94.1±7.0 times /min and 82.6±6.9 times /min) of the patients in the control group. The SBP value (132.9±7.1mmHg) of the patients in the observation group at T3 was significantly higher than that (128.5±6.8mmHg) of the patients in the control group. The DBP value of the patients in the observation group at T3 (78.6±6.8mmHg) and at T4 (80.3±8.3mmHg) were significantly higher than those (85.6±6.0mmHg and 85.7±8.8mmHg) of the patients in the control group (all P<0.05). The levels of IL-6, CRP, TNF-α and NE (92.87 ±13.75ng/L, 15.61 ±2.99mg/L, 7.42±1.96ng/ml and 74.14 ±11.96ng/L) of the patients in the observation group in 12 hours after operation were significantly lower than those (121.81 ±13.99ng/L, 18.79±3.67mg/L, 8.76 ±2.17ng/ml and 82.57 ±15.53ng/L) of the patients in the control group. The scores of MoCA (29.85±1.66 points) and MMSE (29.46±1.11 points) of the patients in the observation group in 3 days after surgery were significantly higher than those (28.92±1.36 points and 28.62±1.06 points) of the patients in the control group. The incidence of the adverse reactions (19.6%) of the patients in the observation group was significantly lower than that (41.0%) of the patients in the control group (all P<0.05). Conclusion: Remimazolam mesylate anesthesia during laparoscopic hysterectomy of the patients has the effect of stabilizing their hemodynamics, improving their inflammatory stress load and protecting their cognition.
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