Effects of remimazolam and midazolam on perioperative anxiety,cognitive function and gastrointestinal function in patients undergoing laparoscopic surgery
Li Wei-dong
Li Juan
Yuan Zhong-wei
Abstract：Objective To explore the effects of remimazolam and midazolam on cognitive and gastrointestinal function in pa-tients with anxiety after laparoscopic surgery. Methods A total of 96 patients receiving laparoscopic surgery in Dandong First Hos-pital from December 2021 to December 2022 were divided into a midazolam group,a remimazolam group and a control group using the random number table method,with 32 in each group. The patients in the remimazolam group received intravenous injection of remi-mazolam,those in the midazolam group received intravenous injection of midazolam,and those in the control group received intrave-nous injection of physiological saline for preoperative sedation before anesthesia induction. General information of all patients includ-ing anesthesia efficacy,postoperative gastrointestinal function,and incidence of adverse events were determined and compared among the three groups. Results The eye opening time,extubation time,and PACU stay time in the remimazolam group were (11.27±1.93) min,(12.64±2.17) min,and (24.08±4.61) min,respectively,lower than those in the midazolam group ((13.44±2.37) min,(14.75±2.53) min,and (27.95±5.33) min,respectively) (P<0.05). These indexes were lower in both the remimazolam group and the midazolam group than in the control ((10.35±1.92) min,(11.23±1.90) min,and (21.72±3.18) min,respectively) (P<0.05). The concentration of S100 β protein in the remimazolam group immediately after surgery and 24 hours after surgery was (573.73±86.97) pg·mL-1,(541.69±87.74) pg·mL-1,respectively,which was lower than that in the midazolam group ( (944.55±91.47) pg·mL-1,(608.32±85.20) pg·mL-1,respectively) (P<0.05). They were lower in both the remimazolam group and the midazolam group than in the control ((1161.36±101.32) pg·mL-1,(731.35±76.14) pg·mL-1,respectively) (P<0.05). The mini mental state examination (MMSE) scores of the remimazolam group immediately after surgery and 24 hours after surgery were (25.41±2.10) points and (26.56±2.33) points,respectively,higher than those of the midazolam group ((24.23±2.14) points and (25.37±2.02) points,respectively) (P<0.05),and they were higher in both the remimazolam group and the midazolam group than in the control ((23.15±2.12) points and (24.21±2.18) points,respectively) (P<0.05). The postoperative first anal exhaust time,first defecation time,and postoperative hospital stay in the remimazolam group and midazolam group were all lower than those in the control group (P<0.05). The I-FEED scores of the remimazolam group and midazolam group were (0.34±0.01) points and (0.33±0.01) points,respectively,both lower than the con-trol group's (1.03±0.24) points (P<0.05). The sleep quality scores of the remimazolam group and midazolam group on the day after surgery were (7.34±1.25) points and (7.29±1.32) points,respectively,both higher than the control group's (6.41±0.98) points (P<0.05). There was no statistically significant difference in Ramsay score and incidence of adverse events among the three groups 30 minutes after surgery (P>0.05). Conclusion Preoperative use of midazolam and remimazolam before anesthesia induction can alleviate preoperative anxiety and promote postoperative gastrointestinal recovery in patients undergoing laparoscopic surgery. Remimazolam shows greater efficacy than midazolam. However,both drugs have a certain impact on postoperative cognitive function.
Keywords：RemimazolamMidazolamLaparoscopic surgeryCognitive functionGastrointestinal function
Publication Date：2024-12-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 774-778 )