Comparison of remimazolam tosylate and propofol in hemodynamic stability, postoperative cognitive function, and recovery in general anesthesia combined with regional nerve blocks: a retrospective cohort study.
Jiaman Li, Li Liao, Chunyang Shao, Yifeng Yang, Yan Tang, Qiang Wei, Li Xu
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引用次数: 0
Abstract
Background: General anesthesia (GA) combined with regional anesthesia (RA) is commonly used to enhance perioperative analgesia and hemodynamic stability. This study aimed to compare the hemodynamic effects and postoperative cognitive function between remimazolam tosylate and propofol in patients undergoing GA combined with RA.
Methods: A retrospective cohort study was conducted on 4408 patients who underwent elective upper or lower limb surgeries at our institution from January 2020 to June 2024. Patients were divided into two groups: Remimazolam (n = 2391) and Propofol (n = 2017). The primary outcomes included hemodynamic parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], mean arterial pressure [MAP]) and postoperative cognitive function (Montreal Cognitive Assessment [MoCA] scores at 24, 48, and 72 h). Secondary outcomes included anesthetic drug consumption, adverse events, and recovery times.
Results: The Remimazolam group was associated with more stable hemodynamic parameters, with significantly higher SBP (121.4 ± 8.3 vs. 112.6 ± 9.2 mmHg, p < 0.05), DBP (72.3 ± 6.1 vs. 67.8 ± 5.9 mmHg, p < 0.05), and MAP (88.3 ± 7.4 vs. 83.1 ± 7.2 mmHg, p < 0.05) compared to the Propofol group. Postoperative cognitive function was superior in the Remimazolam group, with higher MoCA scores at 24, 48, and 72 h (19.6 ± 2.1 vs. 16.3 ± 3.4 at 24 h, p < 0.05). The Remimazolam group also had lower anesthetic consumption (0.16 ± 0.02 vs. 2.4 ± 0.3 mg/kg, p < 0.05), faster recovery times (extubation 8.4 ± 2.1 vs. 11.2 ± 3.4 min, p < 0.05), and fewer adverse events (hypotension: 14% vs. 28%, p < 0.05).
Conclusion: Remimazolam tosylate was associated with more stable hemodynamic parameters, lower rates of postoperative cognitive dysfunction, and shorter recovery times compared to propofol in patients undergoing GA combined with RA, suggesting it may be a safer alternative for patients.
期刊介绍：
BMC Anesthesiology is an open access, peer-reviewed journal that considers articles on all aspects of anesthesiology, critical care, perioperative care and pain management, including clinical and experimental research into anesthetic mechanisms, administration and efficacy, technology and monitoring, and associated economic issues.
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