Analgesic effect of the midazolam-induced anesthesia in different doses on the patients after the thoracoscopic resection of lung cancer

Objective: To elaborate the analgesic efficiency of midazolam-induced anesthesia in different doses on the patients following the thoracoscopic resection of lung cancer. Methods: Ninety patients undergoing thoracoscopic resection of lung cancer between August 2017 and July 2018 were randomized in the observation group (n = 45) and the control group (n = 45). Patients in observation group underwent the anesthesia induced by 0.1 mg/kg midazolam, while for the control group, the dose was adjusted to 0.05 mg/kg. Then, we compared the levels of inflammatory factors, SaO2, average of arterial pressure and changes in heart rate before and after surgery (48 h) to analyze the efficacy. Results: At the postoperative 48 h, patients in the observation group had lower levels of inflammatory factors when comparing with their counterparts in the control group [IL-6, IL-8, IL-1β and TNF-α: (58.44 ± 3.22) μg/L, (2.04 ± 0.26) μg/L, (2.98 ± 0.44) μg/L, (5.33 ± 0.77) μg/L v.s. (96.44 ± 4.54) μg/L, (3.23 ± 0.33) μg/L, (3.77 ± 0.44) μg/L, (7.64 ± 0.99) μg/L] (P < 0.05). Meanwhile, those in the observation group had a lower SaO2, average arterial pressure and heart rate [(93.79 ± 1.08)%, (93.22 ± 3.46) mmHg, (87.55 ± 2.35) beat/min v.s. (97.13 ± 1.03)%, (96.44 ± 4.03) mmHg, (91.05 ± 2.89) beat/min] (P < 0.05). However, no statistical significance was identified in the differences of the bleeding amount, surgical time and anesthesia time between two groups (P > 0.05), while the eye-opening time and the extubation time in the observation group were all shorter than those in the control group (P < 0.05). Similarly, the postoperative pain scores, total doses of propofol and remifentanil were also lowered (P < 0.05). Conclusion: For patients of thoracoscopic resection of lung cancer, midazolam-induced anesthesia (0.1 mg/kg) performs better than 0.5 mg/kg in inhibiting the inflammatory responses, with significant reduction in the dose of anesthetics, thereby stabilizing the status of patients in perioperative period and mitigating the postoperative pains. Thus, it is potential candidate. Keywords: Bronchial lung cancer, Induction dose, Midazolam, Anesthesia, Analgesia