Comparison of Propofol and Remimazolam Tosylate in Patients Undergoing Surgery for Cerebral Hemorrhage and Their Impact on Prognosis

GUO Qianwang; YUAN Conghui; LONG Jihua; JIANG Helin; JIANG Peiyan

doi:10.14033/j.cnki.cfmr.2025.36.007

Abstract：Objective:To observe the application of propofol and remimazolam tosylate in patients undergoing cerebral hemorrhage surgery and their impact on patient prognosis.Method:A total of 92 patients with intracerebral hemorrhage undergoing surgical treatment at Macheng People's Hospital between December 2022 and December 2024 were randomly assigned using a random number table to either the propofol group(n=46)or the remimazolam group(n=46).The propofol group received propofol for intraoperative induction and maintenance of anesthesia,while the remimazolam group received remimazolam tosylate.The perioperative indicators(anesthesia induction time,extubation time,length of hospital stay),vital signs[heart rate(HR),mean arterial pressure(MAP)],neurological function indicators[preoperative and postoperative 24-hour Glasgow Coma Scale(GCS)scores,National Institutes of Health Stroke Scale(NIHSS)scores],adverse events,and outcomes[90-day modified Rankin Scale(mRS)scores]were compared between the two groups.Result:Compared with the propofol group,the remimazolam group demonstrated shorter anesthesia induction time and extubation time,with statistically significant differences(P<0.05).There was no statistically significant difference in hospital stay between the two groups(P>0.05).Mean arterial pressure(MAP)remained higher in the remimazolam group than in the propofol group from the time of tracheal intubation until 5 minutes after discontinuation of the drug,with statistically significant differences(P<0.05).Compared with preoperative levels,both the propofol and remimazolam groups showed increased GCS scores and decreased NIHSS scores at 24 hours postoperatively,with no statistically significant differences(P>0.05).Compared with the propofol group,the rates of respiratory depression,injection pain,and total adverse events were significantly lower in the remimazolam group,with statistically significant differences(P<0.05).Compared with the propofol group,the remimazolam group had significant reductions in the incidence of respiratory depression,injection pain,and total adverse reactions(P<0.05).There were no statistically significant differences between the propofol group and the remimazolam group in terms of 90-day mortality,90-day favorable prognosis rate(mRS score 0-2 points),and 90-day mRS scores(P>0.05).Conclusion:In cerebral hemorrhage surgery anesthesia,compared to propofol,remifentanil tosylate shortens induction and extubation times,maintains hemodynamic stability,and reduces adverse reactions.Both agents demonstrate comparable effects on neurological recovery and long-term prognosis.