Evaluation of anesthesia quality of remimazolam combined with hydromorphone in frail elderly patients undergoing hip replacement
Lin Min
Zhang Yanjie
Shi Kun
Wang Jiao
Qian Min
Chen Xi
Abstract：Objective To explore the effect of remimazolam combined with postoperative hydromorphone on hemodynamics and anesthesia recovery period in elderly frail patients undergoing hip replacement.Methods The study selected 72 elderly frail patients who required hip arthroplasty in Sichuan Province Scientific City Hospital from February 2022 to February 2024.The pa-tients were divided into two groups using a random number table method,with one group receiving remimazolam combined with postoperative hydromorphone anesthesia(remimazolam group)and the other group receiving propofol combined with postoperative hydromorphone anesthesia(propofol group).The two groups were compared in terms of hemodynamic parameters,anesthesia recov-ery parameters,40-item Quality of Recovery(QoR-40),Montreal Cognitive Assessment(MoCA),Mini-Mental State Examination(MMSE),Visual Analog Scale(VAS)scores,and anesthesia-related adverse reactions.Results There were no significant differ-ences in heart rate(HR),mean arterial pressure(MAP)at T0 and T3,or HR at T1 between the two groups(P>0.05).At T1 and T2,the remimazolam group had higher MAP values(T1:(72.13±8.04)mm Hg(1 mm Hg≈0.133 kPa),T2:(74.13±7.18)mm Hg)compared to the propofol group(T1:(68.04±7.89)mm Hg,T2:(63.40±57.36)mm Hg)(t=2.178,6.261,both P<0.05).At T2,the remimazolam group had a higher HR(72.36±4.36)times·min-1 compared to the propofol group(63.81±5.37)times·min-1(t=7.416,P<0.001).There was no significant difference in Post-Anesthesia Care Unit(PACU)stay time between the two groups(P>0.05).The remimazolam group had a shorter eye-opening time and extubation time((11.21±2.12)min,(12.35±3.21)min)compared to the propofol group((13.39±2.06)min,(16.90±4.11)min)(t=4.425,5.235,both P<0.001).There was no significant difference in VAS scores at 6 hours postoperatively(P>0.05).At 12 hours and 24 hours postoperatively,the remimazolam group had lower VAS scores(12 h:(2.41±0.78),24 h:(1.71±0.33))compared to the propofol group(12 h:(3.08±0.71),24 h:(2.03±0.30))(t=3.811,4.305,P<0.001).There were no significant differences in QoR-40 scores between the two groups(P>0.05).The remimazolam group had higher MoCA scores and MMSE scores((23.02±4.15)scores,(24.23±3.61)scores)than the propofol group((20.06±3.91)scores,(19.78±3.33)scores)(t=3.115,5.436,both P<0.05).There were no significant differences in the incidence of wound bleeding or rupture,nausea and vomiting,hypo-tension,or hypoxemia between the two groups(P>0.05).The total incidence of adverse reactions was not significantly different be-tween the two groups(P>0.05).Conclusion Remimazolam combined with postoperative hydromorphone has good hemodynamic stability and anesthesia recovery effect in hip replacement in elderly frail patients since it can effectively reduce postoperative pain and improve cognitive function.
Keywords：RemimazolamHydromorphoneElderly frail patientHip replacementHemodynamicsAnesthesia recovery period
Publication Date：2025-08-25
Online Publishing Date：2025-09-01(First online date of this platform, not the publication date of the document)
Pages：5( 860-864 )