关键词: 胆囊切除术, 腹腔镜, 麻醉, 全身, 瑞马唑仑, 咪达唑仑

Abstract: Objective  To study the effect of remazolam and midazolam on postoperative cognitive function of patients undergoing laparoscopic cholecystectomy(LC) under general anesthesia. 
Methods  A total of 160 patients undergoing LC under general anesthesia were divided into observation group(n=80) and control group(n=80) according to random number table method. In the observation group, 0.30 mg/kg remazzolam, 0.50 μg/kg sufentanil and 0.60 mg/kg rocuronium were injected intravenously during anesthesia induction. In the control group, 0.05 mg/kg midazolam, 0.50 μg/kg sufentanil and 0.60 mg/kg rocuronium were used during anesthesia induction. The changes of mean arterial pressure(MAP) and heart rate(HR) were recorded at anesthesia induction(T0), bispectral index＜60(T1) and after intubation(T2). Eye opening time, extubation time and duration of postanesthesia care unit(PACU) stay after anesthesia, score level of mini-mental state examination(MMSE) before operation, at 24 h and 72 h after operation, and incidence of postoperative adverse reactions were recorded. 
Results  The MAP of the two groups was decreased first and then increased, while the change range of MAP in the observation group was smaller than that in the control group, while HR in the observation group was increased gradually. There were significant differences in interaction between groups, time points and time points between groups(P＜0.05). The eye opening time, extubation time and duration of PACU stay of patients in the observation group were significantly shorter than those in the control group, suggesting significant difference(P＜0.05). The MMSE scores of the two groups were decreased initially and then increased. The change range of MMSE scores of the observation group was smaller than that of the control group, and there were significant differences in interaction between groups, time points and time points between groups(P＜0.05). The incidence of hypotension in the observation group was lower than that in the control group, and the difference was statistically significant(P＜0.05). There was no significant difference in the incidence of respiratory depression, restlessness, dizziness, headache and sleepiness between two groups(P＞0.05). 
Conclusion  Compared with midazolam, remazolam has better safety, less influence on cognitive function, faster recovery from anesthesia and fewer adverse reactions in LC.

Key words: cholecystectomy, laparoscopic, anesthesia, general, ramazolam, midazolam