Comparison Of The Effects Of Different Doses Of Remimazolam On Hemodynamics During Induction Of Anesthesia In Cardiac Surgery

Objective: To investigate the optimal induction dose of rimazolam during induction of anesthesia for cardiac surgery that meets the depth of anesthesia requirement with minimal hemodynamic impact.Methods: Sixty cardiac surgery patients aged 45-70 years treated at Second Affiliated Hospital of Dalian Medical University from June to December 2022 were studied and divided into R1 group(20 cases),R2 group(20 cases)and R3 group(20 cases)according to the method of random number table.After admission,electrocardiogram(ECG),pulse oximetry(SPO2),and cuff blood pressure were monitored,and ultrasound-guided radial artery puncture placement was performed to monitor invasive arterial pressure and mean arterial pressure(MAP),and BIS monitoring was established before induction of anesthesia.In group R1,anesthesia was induced with rimazolam 0.15 mg/kg;in group R2,anesthesia was induced with rimazolam 0.2 mg/kg;and in group R3,anesthesia was induced with rimazolam 0.25 mg/kg.After the BIS of patients in the three groups dropped below 60,benzosulfanil cisatracurium 0.2 mg/kg was administered intravenously,and after complete muscle relaxation,sufentanil 0.5ug/kg and remifentanil 2ug/kg were administered intravenously.kg,and 1 minute later,the trachea was intubated under Airtraq video laryngoscope with clear vision.In all three groups,sevoflurane VOL%1-1.5% was inhaled to maintain BIS 40-50 after tracheal intubation,and ultrasound-guided central venipuncture placement was performed.Heart rate(HR),mean arterial pressure(MAP),electroencephalographic bifrequency index(BIS),dose of vasoactive drugs used during T0-T4 and additional dose of remazolam were recorded in the three groups before induction of anesthesia(T0),before tracheal intubation(T1),1 min after tracheal intubation(T2),5 min after tracheal intubation(T3)and 10 min after tracheal intubation(T4).Results: Data from 20 patients in each of the final groups were analyzed.There were no statistically significant differences in the general data(gender,age,BMI)between the three groups(P>0.05),no statistically significant differences in the type of procedure compared between groups(P>0.05),no statistically significant differences in heart rate(HR)compared between groups(P>0.05),no statistically significant differences in mean arterial pressure(MAP)were not statistically significantly different between groups(P>0.05),and the use of vasoactive drugs(norepinephrine)was not statistically different(P>0.05).In the R1 group(rimazolam 0.15 mg/kg),the probability of additional dosing was higher than in the other two groups(P>0.05);in the R3 group(remazolam 0.25 mg/kg)the probability of BIS less than 40 anesthesia too deep was higher than in the other two groups(P >0.05).Conclusion: Three different doses of rimazolam used for induction of general anesthesia for cardiac surgery in middle-aged and elderly patients showed no significant differences in hemodynamic effects,and 0.2 mg/kg was the most appropriate dose to achieve a reasonable depth of anesthesia.