Effects of General Anesthesia with Remimazolam on Hemodynamics,Post-operative Analgesia and Sedation,Liver and Kidney Function and Safety in Elderly Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer

ZHAO Shu; QIU Shichao; ZHAO Mingqiang

doi:10.3969/j.issn.1002-3429.2025.08.015

Abstract：Objective To investigate the application effect of general anesthesia with Remimazolam in elderly patients undergoing thoracoscopic radical resection of pulmonary carcinoma(RRPC).Methods From March 2022 to September 2023,87 elderly patients undergoing thoracoscopic RRPC were selected and divided into two groups by random number table method.Forty-five patients in the observation group were given general anesthesia with Remimazolam,and 42 patients in the control group were given general anesthesia with Midazolam.The surgical anesthesia-related indicators,changes of mean arte-rial pressure(MAP)and heart rate(HR)immediately before anesthesia induction(T1),immediately after intubation(T2),at 40 min after operation(T3),and immediately before extubation(T4)were compared between the two groups.The Steward recovery score at 2,4,6,and 12 h after operation was compared between the two groups.The visual analogue scale(VAS)pain score at 6,12,24,48 h after operation,the levels of liver and kidney function indexes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),albumin(ALB),serum creatinine(Scr),blood urea nitrogen(BUN)]at 12 h after operation,and the adverse reactions and complications caused by anesthesia were recorded.Results The total dosage of Sufentanil in the two groups was lower than that in the control group(P＜0.01).In the observation group,MAP at T2,T3 and T4 was lower than that at T1(P＜0.05).Except HR at T1 and T4 that showed no significant difference,there was signif-icant difference between the other time points and T1(P＜0.05).In the control group,MAP at T2,T3 and T4 was lower than that at T1,while HR was higher than that at T1(P＜0.05).The fluctuations of MAP and HR at T2,T3 and T4 in the observation group were smaller than those in the control group(P＜0.05,P＜0.01).Steward recovery scores at 2,4 and6 h after operation in the observation group were significantly higher than those in the control group(P＜0.01).The VAS pain score of the observation group was lower than that of the control group at 6 h after operation(P＜0.01),and the levels of postoperative AST,ALB,Scr,and BUN in the observation group were significantly lower than those in the control group at 12 h after operation(P＜0.01).The incidence of adverse reactions and complications in the observation group was 6.67%(3/45)and 11.11%(5/45),respectively,which were lower than 23.81%(10/42)and 28.57%(12/42)in the control group,and the differences were significant(P＜0.05).Conclusion General anesthesia with Remimazolam applied in elder-ly patients undergoing thoracoscopic RRPC can reduce perioperative hemodynamic fluctuations,promote postoperative recovery,reduce early postoperative pain,protect liver and kidney function,and has good safety.