Comparison of the effects of remimazolam and propofol anesthesia on postoperative delirium in elderly patients with lung cancer undergoing thoracoscopic surgery
10.3969/j.issn.1006-5725.2025.19.020
- VernacularTitle:瑞马唑仑与丙泊酚麻醉对胸腔镜手术的老年肺癌患者术后谵妄的影响
- Author:
Xi CHEN
1
;
Beibei YU
;
Yuge LIU
;
Wei ZHAO
;
Ming YAN
Author Information
1. 徐州医科大学附属医院麻醉科(江苏 徐州 221002);徐州医科大学江苏省麻醉学重点实验室(江苏 徐州 221000)
- Publication Type:Journal Article
- Keywords:
remimazolam;
propofol;
thoracoscopic surgery;
postoperative delirium
- From:
The Journal of Practical Medicine
2025;41(19):3089-3095
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of remimazolam on the incidence of postoperative delirium(POD)in elderly lung cancer patients undergoing thoracoscopic surgery.Methods A total of 114 elderly patients who underwent unilateral thoracoscopic lung surgery at the Affiliated Hospital of Xuzhou Medical University from October 2024 to April 2025 were recruited in this trial.Patients were randomly assigned to remimazolam group(group R)and propofol group(group P).Anesthesia induction and maintenance were performed with remimazolam and propofol,respectively.In R group,0.5 mg of flumazenil was intravenously injected at the end of the surgery for specific antagonism.The incidence of delirium and Quality of Recovery-15(QoR-15)scores on the first and third postoperative days were compared between the two groups.Intraoperative hemodynamic parameters,total opi-oid dosage,fluid balance,tracheal tube extubation time after surgery,and the incidence of adverse reactions were recorded.Results There were no statistically significant differences between the groups in the incidence of POD or in QoR-15 scores(P>0.05).Compared with group P,patients in group R had a shorter extubation time(P<0.05),more stable hemodynamics,lower incidences of intra-operative hypotension and bradycardia,and reduced requirement for vasoactive drugs(P<0.05).The consumption of rescue analgesics in the post-anesthesia care unit(PACU)was also lower in group R(P<0.05).No significant differences were observed between the groups in the amounts of sufentanil and remifentanil administered,fluid balance,bispectral index(BIS)values,or the inci-dence of nausea and vomiting(P>0.05).Conclusion In elderly patients undergoing elective thoracoscopic sur-gery,remimazolam-based induction and maintenance of anesthesia did not significantly alter the incidence of POD or compromise postoperative recovery quality compared with propofol.However,the remimazolam group required fewer vasoactive agents and exhibited a shorter tracheal extubation time.
