Anesthetic Effect Of Remimazolam Tosilatein On Laparoscopic Cholecystectomy In Elderly Patients

Objective To observe the anesthetic effect of Remimazolam Tosilatein elderly patients undergoing laparoscopic cholecystectomy,optimize the selection and management of perioperative anesthetic drugs,and promote the postoperative rehabilitation of patients.Methods From February 2021 to September 2021,64 elderly patients aged 65 to 80 years who underwent laparoscopic cholecystectomy under general anesthesia in our hospital were selected as the study subjects.According to the random number table method,they were divided into propofol group(P group)and different doses of remimazolam group(R1 group,R2 group,R3 group),with 16 cases in each group.During anesthesia induction,the propofol group received intravenous injection of2mg/kg,while the remimazolam group received intravenous injection of 0.2mg/kg,0.25mg/kg,and 0.3mg/kg,respectively.Sufentanil 0.4μg/kg was given to all four groups of patients,when BIS≤60,inject 0.15mg/kg of cisatracurium,and intubate after meeting the conditions for tracheal intubation.Monitor and record the time required from anesthesia induction to BIS≤60,BIS value before tracheal intubation,awakening time(from drug withdrawal to eye awakening),and extubation time(from drug withdrawal to tracheal catheter removal);Monitor the changes in vital signs of four groups of patients before anesthesia(T1),immediately after intubation(T2),3 minutes after intubation(T3),3 minutes after skin incision(T4),and after surgery(T5);Record the number of times sedation and related adverse reactions(such as hypotension,respiratory suppression,bradycardia,injection pain,postoperative nausea and vomiting,etc.)need to be remedied in four groups of patients,as well as the scores on the Minimal State Examination(MMSE)before,1 day after,and 3 days after surgery.Results From the time of induction to BIS≤60,R1 group>R2 group>R3 group>P group,the differences were statistically significant(P<0.05).Compared with P group,the three groups of R1,R2 and R3 wake-up time and extubation time were shortened,and the difference was statistically significant(P<0.05).Four groups The MMSE scores of the patients all showed a trend of first decreasing and then increasing,but the changes in the scores of the R1,R2,and R3 groups were smaller than that of the P group,and the differences in the interaction between groups,time points,and groups·time points were statistically significant(P<0.05).The total incidence of adverse reactions in the three groups was less than that in group P,and the difference was statistically significant(P<0.05).The R3 group had the shortest time to achieve the required sedation depth for surgery compared with the R1 and R2 groups,but the incidence of related adverse effects was higher;The R1 group had the highest number of cases requiring rescue sedation;The MAP at T2-T5 time point was basically the same among the three groups,with no significant difference(P>0.05),which indicated that the change of the dosage of remazolam had little effect on the hemodynamics.Conclusion For elderly patients undergoing laparoscopic cholecystectomy,the anaesthetic efficacy of remazolam mesylate was superior to that of propofol,with the use of doses in group R2(0.25 mg / kg)resulting in rapid induction,fewer adverse effects,and a higher safety profile,consistent with anaesthesia...