Effect of remimazolam combined with estazolam on anxiety levels and postoperative gastrointestinal function recovery in patients undergoing laparoscopic cholecystectomy surgery.

Abstract

Purpose: The objective of this study is to examine the impact of administering remimazolam and estazolam in alleviating preoperative anxiety on the recovery of gastrointestinal function in patients undergoing laparoscopic cholecystectomy surgery.

Materials and methods: A total of 140 patients who were scheduled for elective laparoscopic cholecystectomy surgery were randomly divided into four groups using random number table: remimazolam group (group R, n = 35), estazolam group (group E, n = 35), remimazolam combined with estazolam group (group RE, n = 35), and control group (group C, n = 35). Group R received an intravenous injection of remimazolam before the administration of anesthesia, group E was orally administered estazolam on the night before surgery and intravenously injected with normal saline before induction of anesthesia, group RE received both estazolam orally on the night before surgery and intravenous injection of remimazolam before induction of anesthesia, and group C was given normal saline before induction of anesthesia. The visual analogue scale for anxiety (VAS-A) scores were documented during the preoperative visit, following entry into the operating room, and 10 min after intravenous remimazolam or normal saline. Time to the first postoperative exhaust and defecation, occurrence of nausea and vomiting within 24 h after surgery, sleep quality scores on the night before surgery and two nights after surgery as per Numerical Rating Scale (NRS), postoperative patient satisfaction, and occurrence of adverse reactions were also recorded.

Results: In contrast to group C, time to the first postoperative exhaust and defecation of groups R, E, and RE were significantly reduced (P < 0.05); the VAS-A scores of groups E and RE exhibited a significant decrease upon entering the operating room, and the VAS-A scores of groups R, E, and RE decreased significantly 10 min after intravenous remimazolam or normal saline (P < 0.05); sleep quality scores of groups R, E, and RE were significantly higher on the first night after surgery (P < 0.05). There was no significant difference in the occurrence of nausea and vomiting among the four groups within 24 h after surgery. No adverse reactions such as wound bleeding, infection, and severe abdominal distension occurred in the four groups.

Conclusions: The utilization of remimazolam and estazolam, either singularly or in combination, before laparoscopic cholecystectomy surgery, has shown considerable efficacy in alleviating preoperative anxiety, and thus expediting the recovery of postoperative gastrointestinal function in patients. Moreover, the combination of both agents can improve the patient's postoperative sleep quality, thereby elevating patient satisfaction.