Impact of different doses of remimazolam on anesthetic analgesic effects and hemodynamics in patients undergoing radical hepatectomy

Zhou Yi; Wang Xiao-dong; Jin Tao; Wang Jian-hua; Lan Ji-shan; Qi Shao-xia

doi:10.3969/j.issn.1672-8157.2025.01.023

Abstract：Objective To investigate the effect of different doses of remimazolam on hemodynamics during anaesthet-ic induction in invalids undergoing radical hepatectomy.Methods A total of 90 patients undergoing radical resection of liv-er cancer in Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2022 to December 2023 were selected as the research subjects and divided into group A(n=30),group B(n=30)and group C(n=30)according to the random number table method.Remimazolam was used in combination with sufentanil for anesthesia induction in all the threee groups.The dose of remimazolam used was 0.1 mg·kg-1 in group A,0.15 mg·kg-1 in group B and 0.2 mg·kg-1 in group C.The anesthesia induction and sedation effects,hemodynamic indicators(heart rate(HR),mean arterial pressure(MAP)and pulse ox-imetry(SpO2))at the beginning of induction(T0),when BIS value≤60(T1)and after tracheal intubation(T2),visual analogue score(VAS)at 1 h,12 h,and 24 h after surgery,and adverse reactions were compared among the three groups.Results The onset of anesthesia in group A was longer than that in groups B and C((73.45±15.06)s vs(61.28±10.46)s vs(50.43±6.35)s),and the difference was statistically significant(F=31.634,P<0.001).Sedation efficient was increased in order from group A to group C(70.00%vs 96.67%vs 100.00%)(χ2=16.425,P<0.001).At T0～T2,HR values were gradually increased in all the three groups,while MAP values and SpO2 values decreased first and then increased,showing statistical significance(F=109.716,78.389,213.786,P<0.001).At T0,T1 and T2,there was no significant difference in HR and MAP values among the three groups(F=0.014,0.022,P>0.05).At T1 and T2,the SpO2 value in group A was the lowest,and that in group C was the highest(F=7.059,P<0.05).From 1 h to 24 h after surgery,the VAS scores were gradually increased in all the three groups.At different time points,the VAS scores in group A were the highest,while those in group C were the lowest.The differences were statistically signif-icant(F=1 197.006,48.542,2.718,P<0.05).The total incidence of adverse reaction was 3.33%in group A,6.67%in group B and 10.00%in group C.However,there was no statistically significant difference among the three groups(χ2=3.108,P>0.05).Conclusion When remimazolam is used for anesthesia induction in radical liver cancer surgery,as the dose increases,the onset of action is shorter and the sedation effect is better.However,different doses of remimazolam have an impact on the intraopera-tive hemodynamics of patients.There is little difference in postoperative adverse reactions,among which 0.15 mg·kg-1 was the optimal dose.