Application of Remimazolam Tosylate for Induction and Maintenance of General Anesthesia in Gynecological Laparoscopic Surgery
ZHENG Jianyu
LI Donghong
CHEN Shaoyi
SHENG Hengwei
HUANG Minzhen
HUANG Guangyong
HE Jianfang
Abstract：Objective To investigate the efficacy of remimazolam tosylate for induction and maintenance of general anesthesia in gynecological laparoscopic surgery.Methods Eighty patients scheduled for elective gynecological laparoscopic surgery at Foshan Sanshui District People's Hospital between January 2023 and July 2024 were selected using a random number table method and divided into two groups:the propofol group(n=40)and the remimazolam group(n=40).The anesthesia induction protocol was as follows:the propofol group received intravenous injection of propofol emulsion injection at 2 mg/kg,while the remimazolam group received intravenous injection of remimazolam tosylate at 0.3 mg/kg;both groups subsequently received intravenous injections of sufentanil 0.4 μg/kg and rocuronium bromide 0.6 mg/kg in sequence.For anesthesia maintenance:the propofol group received intravenous pump infusion of propofol at 4-10 mg/(kg·h),while the remimazolam group received intravenous pump infusion of remimazolam tosylate at 0.3-1.5 mg/(kg·h);both groups received intravenous pump infusion of remifentanil at 0.1-0.2 μg/(kg·min).Perioperative related indicators were compared between the two groups[time to loss of consciousness,eye opening time,time for Narcotrend index(NI)value to decrease to D0,time for bispectral index(BIS)to reach the lowest value before intubation,operation time,anesthesia time],as well as recovery quality at 10,20,and 30 minutes after drug discontinuation.Changes in hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP),blood oxygen saturation]were recorded before anesthesia induction(T0),at loss of consciousness(T1),at the start of surgery(T2),30 minutes after surgery start(T3),and after awakening(T4).Cortisol(Cor)and blood glucose levels were measured preoperatively,and at 6 hours and 24 hours postoperatively.Cognitive function was assessed using the Mini-Mental State Examination(MMSE)preoperatively,and on postoperative day 1 and day 3.The incidence of adverse reactions was recorded.Results Compared with the propofol group,the remimazolam group had a longer time to loss of consciousness,a longer time for the NI value to decrease to D0,a longer time for BIS to reach the lowest value before intubation,and a shorter eye opening time(P<0.05).At 30 minutes after drug discontinuation,the Steward score of the remimazolam group was higher than that of the propofol group(P<0.05).From T1 to T3,HR and MAP in the remimazolam group were higher than those in the propofol group(P<0.05).At 6 hours and 24 hours postoperatively,Cor and blood glucose levels in the propofol group were higher than those in the remimazolam group(P<0.05).On postoperative day 1 and day 3,the MMSE scores of the remimazolam group were higher than those of the propofol group(P<0.05).The overall incidence of adverse reactions in the remimazolam group was 12.50%,which was lower than the 55.00%in the propofol group(P<0.05).Conclusions Compared with propofol,remimazolam tosylate provides a shorter recovery time,better recovery quality,more stable intraoperative heart rate and blood pressure,less postoperative stress,faster recovery of cognitive function,and a lower incidence of adverse reactions.It can be safely and effectively used for induction and maintenance of general anesthesia in patients undergoing gynecological laparoscopic surgery.
Keywords：remimazolam tosylategynecological laparoscopic surgerypropofolhemodynamics
Publication Date：2025-11-20
Online Publishing Date：2025-11-24(First online date of this platform, not the publication date of the document)
Pages：6( 154-159 )