Anesthetic efficacy of midazolam in patients with lung cancer complicated with emphysema undergoing surgery
Zhu Shan
Zhang Yan-mei
Cao Han-zhong
Wang Hao-ran
Liu Lei
Zhang Hui
Kang Pei-pei
Abstract：Objective To observe the efficacy of midazolam in patients with lung cancer complicated with emphysema. Methods A total of 195 patients with lung cancer complicated with emphysema admitted to Nantong Tumor Hospital from Janu-ary 2023 to December 2023 were divided into the control group (n=97) and midazolam group (n=98) by random number table method. In the control group,anesthesia was induced by 0.5 μg·kg-1 sufentanil,0.15 mg·kg-1 benzoatracurium sulfonate,and 1 mg·kg-1 propo-fol. After mechanical ventilation with tracheal intubation,0.1 mg·(kg·h)-1 propofol and 0.3 μg·(kg·h)-1,0.15 mg·kg-1 benzoatracurium sulfonate remifentanil were injected intravenously to maintain anesthesia. In the midazolam group,0.05 mg·kg-1 midazolam was used on the basis of the regimen in the control group. The heart rate (HR),oxygen saturation (SpO2) and mean arterial pressure (MAP) levels were compared at the beginning of anesthesia (T0),BIS<75 (T1) and after intubation (T2). The cognitive function and inflam-matory factor levels were compared before and 1 d after operation between the two groups. The occurrence of postoperative adverse reactions was observed. Results HR increased gradually in both groups,and it was lower in the midazolam group than in the con-trol. MAP decreased firstly and then increased in the two groups,with the largest change in the control group and the smallest change in the midazolam group. There were significant differences in HR,MAP,time and interaction between the two groups,and no differ-ence in SpO2 interaction between the two groups (F=5.025,3.841,0.314,all P<0.05). One day after surgery,the Montreal Cognitive Assessment Scale scores decreased in both groups,and they were higher in the midazolam group ((24.98±0.92) points) than in the control group ((23.78±0.82) points) (t=9.611,P<0.05). Serum tumor necrosis factor-α,interleukin-1β,interleukin-6,and recombinant human chemokine 8 levels were elevated in both groups and they were higher in the control group ((18.65±3.16) pg·mL-1,(16.17±3.18) pg·mL-1,(26.33±4.21) pg·mL-1,(73.28±11.65) ng·mL-1) than in the midazolam group ((15.31±2.83) pg·mL-1,(11.36±2.58) pg·mL-1,(18.79±3.93) pg·mL-1,and (67.42±10.17) ng·mL-1) (t=7.777,11.604,12.929,3.743,all P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (5.10％ vs 8.24％) (x2=0.775,P>0.05). Conclusion Midazolam has better anesthetic effect on patients undergoing surgery for lung cancer complicated with emphysema because it can reduce the impact on hemodynamics and postoperative cognitive function of patients,and reduce the level of serum inflammatory factors,and is of high safety.
Keywords：MidazolamLung cancerEmphysemaEfficacyAdverse reaction
Publication Date：2024-12-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 764-767 )