Abstract: Objective To investigate the anesthetic effect of lidocaine combined with midazolam and cis-atracurium in laparoscopic cholecystectomy. Methods A total of 90 patients with laparoscopic cholecystectomy who were admitted to the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from July 2019 to January 2022 were selected and divided into expermental group (n=45) and control group (n=45) according to the random table method. The control group was given midazolam, cisatracurium, sufentanil and propofol for anesthesia induction. The experimental group was given lidocaine for anesthesia induction on the basis of the control group. The recovery time of the first bowel sound and the first anal exhaust time, visual analogue scale (VAS) score at different postoperative time, the expression level of angiotensin Ⅱ(Ang Ⅱ) at 2 h after surgery, the levels of adrenaline (E), norepinephrine (NE), cortisol (Cor), T lymphocyte subsets CD8⁺, CD4⁺, CD3⁺, and self were compared between the two groups NK cell level, CD4⁺/CD8⁺ ratio and adverse reaction rate. Results The recovery time of the first bowel sound and the first anal exhaust time in the experimental group were shorter than those in the control group (P<0.05). It was lower than the control group (P<0.05), and the VAS scores between the two groups at different times were compared,the difference was statistically significant (P<0.05); the levels of Ang II, E, NE, and Cor were compared between the two groups before operation,the difference was not statistically significant (P>0.05). The levels of the above indexes increased at 2 h, but the experimental group was lower than the control group (P<0.05); the comparison of CD8⁺, CD4⁺, CD3⁺, NK, CD4⁺/CD8⁺ indexes 30 minutes before anesthesia induction between the two groups,the difference was not statistically significant (P>0.05), the above indexes in both groups showed a downward trend 24 hours after operation, and the levels of CD4⁺, CD3⁺, NK and CD4⁺/CD8⁺ indexes in the experimental group were higher than those in the control group (P<0.05), and the CD8⁺ levels in the two groups were compared,the difference was not statistically significant (P>0.05). There was no statistically differencein the adverse reaction rate of respiratory depression, hypotension, restless hess during awakening between the experimental group and the control group (P>0.05). Conclusion Lidocaine combined with midazolam and cis-atracurium for anesthesia induction in laparoscopic cholecystectomy can shorten the recovery time of the first bowel sound and the time of the first anal exhaust, relieve postoperative pain, relieve the body’s stress response, improve immune function. Meanwhile, it has a certain safety, and is worthy of clinical application.

Key words: lidocaine, midazolam, cis-atracurium, laparoscopic cholecystectomy, anesthesia effect