Prospective study on the application of remazolam toluene sulfonate in induction of anesthesia in children

CHEN Rongfeng; CAI Yingmin

doi:10.3969/j.issn.2096-2681.2025.01.005

Abstract：Objective To compare remazolam with propofol and observe its safety and effectiveness in pediatric surgeries for providing reference for a more ideal anesthesia induction program.Methods A total of 120 pediatric patients undergoing elective general anesthesia in the First Hospital of Hanbin District of Ankang City from November 2021 to January 2023 were selected and randomly divided into propofol 2.5 mg/kg group(group B,n=40),remazolam 0.30 mg/kg group(group R1,n=40)and remazolam 0.35 mg/kg group(group R2,n=40).Two minutes after intravenous sufentanil injection,propofol or remazolam and rocuronium were injected successive-ly;endotracheal intubation was performed after the depth of anesthesia and muscle relaxation were assessed.The mean arterial pressure(MAP),heart rate(HR),BIS value and MOAA/S score were recorded at different induction time points.Eight different time nodes were observed,at the time of entry(T0),before the first infusion of sufentanil(T1),2 min after the first infusion of sufentanil(T2),1 min after the infusion of induction drugs for general anesthesia(T3),3 min after the infusion of induction drugs for general anesthesia(T4),when the tracheal intubation entered the glottis(T5),and 1 min after the tracheal intubation was completed(T6),3 min after endo-tracheal intubation is completed(T7).Results The MAP of groups R1 and R2 at T3 and T4 was higher than that of group B,the HR of groups R1 and R2 at T4 and T5 was higher than that of group B,and the BIS value of groups R1 and R2 at T3,T4,T5,T6 and T7 was higher than those of group B,with statistical significance(P＜0.05).The incidence of intraoperative blood pressure decrease in group R1 and group R2 was significantly lower than that in group B,and the difference was statistically significant(P＜0.05).Conclusion Remazolam can be used for rapid sequential induction of intubation anesthesia in 1-12 years old patients.After injection of remazolam,BIS values are higher in pediatric patients.Thus BIS value is not suitable for evaluating the sedation depth of remazolam during anesthesia induction.