Efficacy of remazolam combined with remifentanil anesthesia for radical surgery for gastric cancer in frail aged patients / 中华麻醉学杂志

ABSTRACT

Objective:To evaluate the efficacy of remazolam combined with remifentanil anesthesia for radical surgery for gastric cancer in frail aged patients.Methods:One hundred and twenty patients of either sex, aged 65-75 yr, with body mass index 18-28 kg/m 2, with simple frailty questionnaire score 3-5 points, undergoing elective laparoscopic radical gastric cancer surgery, were divided into 3 groups ( n=40 each) according to the random number table method: propofol combined with remifentanil group (P group), low-dose remazolam combined with remifentanil group (B1 group) and high-dose remazolam combined with remifentanil group (B2 group). Induction of anesthesia was as follows propofol 2 mg/kg was intravenously injected in group P, remazolam 6 and 12 mg·kg -1·h -1 were intravenously infused in group B1 and group B2, respectively, and alfentanil and rocuronium were intravenously injected after loss of consciousness in three groups.Anesthesia maintenance was as follows propofol 4-12 mg·kg -1·h -1 was intravenously infused in group P, remazolam 0.5-1.0 mg·kg -1·h -1 was intravenously infused in B1 and B2 groups, remifentanil 0.05-0.20 μg·kg -1·h -1 was intravenously infused in three groups, and intravenous rocuronium was injected intermittently to maintain the BIS value at 45-55 intraoperatively.The time to loss of consciousness, recovery time of consciousness and time of tracheal extubation were recorded.The occurrence of injection pain during induction of anesthesia, intraoperative cardiovascular events, intraoperative awareness, and respiratory depression, nausea and vomiting, and drowsiness during postanesthesia care unit were recorded. Results:Compared with group P, the time to loss of consciousness was significantly prolonged, the incidence of injection pain, intraoperative hypotension and bradycardia was decreased, and the incidence of postoperative somnolence was increased in B1 and B2 groups ( P<0.05). The time to loss of consciousness was significantly shorter in group B2 than in group B1 ( P<0.05). There was no statistically significant difference in the recovery time of consciousness, time of tracheal extubation, postoperative respiratory depression and incidence of nausea and vomiting among the three groups ( P>0.05). Conclusion:Remazolam combined with remifentanil anesthesia can be safely and effectively used for radical surgery for gastric cancer in frail aged patients.