Effect of Remimazolam on Postoperative Delirium in Elderly Patients Undergoing Off-Pump Coronary Artery Bypass Grafting
ZHANG Liyuan
YANG Muqiang
SI Jianluo
LIU Weifeng
Abstract：Objective To assess the effects of remimazolam on postoperative delirium(POD)in elderly patients undergoing off-pump coronary artery bypass grafting(OPCABG).Methods Seventy elderly patients aged 65-79 years old were enrolled in the operating room of the First Affiliated Hospital of Henan University of Science and Technology to receive OPCABG.Random number table method was used to divide the experimental group and the control group,35 cases each.In experimental group,remimazolam was administered intravenously at a dose of 0.15-0.35 mg·kg-1 for induction and 0.3-1.0 mg·kg-1·h-1 for maintenance of anesthesia.In the control group,propofol was administered intravenously at a dose of 1.0-2.5 mg·kg-1 for induction and 4-12 mg·kg-1·h-1 for maintenance of anesthesia.Other methods of anesthesia induction and maintenance were consistent between the two groups.POD was assessed within 3 days after surgery using the confusion assessment method for the intensive care unit(CAM-ICU).The quality of recovery was evaluated on the first and second postoperative days using the 15-item quality of recovery questionnaire(QoR-15).Preoperative and postoperative blood routine tests were recorded.The times of anesthesia recovery,extubation,ICU stay,and postoperative hospital stay were recorded.The incidence of postoperative adverse events was statistically analyzed.Results Within 3 days after surgery,12 patients(34.3％)in experimental group experienced POD,while 23 patients(65.7％)did not.In the control group,14 patients(40.0％)experienced POD,while 21 patients(60.0％)did not.There was no statistical significance between the two groups(P＞0.05).On the first and second postoperative days,the QoR-15 scores of the patients in experimental group were higher than those in the control group on the first and second days after operation(P＜0.05).The white blood cell counts,neutrophil counts,and neutrophil percentages on postoperative days 1 and 3 were elevated compared to preoperative day 1 values in both groups(P＜0.05).However,the experimental group showed smaller increases in white blood cell counts,neutrophil counts,and neutrophil percentages on postoperative days 1 and 3 compared to the control group(P＜0.05).Additionally,the experimental group demonstrated shorter durations in anesthesia recovery time,tracheal extubation time,and ICU stay length when compared to the control group(P＜0.05).The occurrence rates of sinus bradycardia and hypotension were lower in experimental group than in the control group(P＜0.05).Conclusion Remifentanil for induction and maintenance of general anesthesia in elderly patients undergoing OPCABG does not increase the incidence of POD and can improve the quality of postoperative recovery in patients.
Keywords：postoperative deliriumremimazolampropofolcardiac surgeryelderly
Publication Date：2025-03-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：7( 799-805 )