Effect Of Remimazolam Tosilate On Circulatory Function In Elderly Patients During Induction Of General Anesthesia

Objective The purpose of this study was to investigate the effect of remimazolam tosilate on circulatory function in elderly patients during general anesthesia induction.Methods A total of 100 elderly patients(aged≥65 years)who underwent endotracheal intubation for lower digestive tract tumor resection in Chifeng Hospital from February 2021 to September 2021 were randomly divided into two groups:remimazolam tosilate group(group R)and etomidate group(group E).General anesthesia was induced with remimazolam tosilate and etomidate respectively.The patients were routinely fasted from drinking and fasting.After entering the room,routine monitoring of electrocardiogram(ECG),pulse oxygen saturation(SpO2),non-invasive blood pressure(NIBP),bispectral index(BIS).After the peripheral venous pathway was established,the radial artery catheterization was performed and the vigileo monitor was connected.General anesthesia was induced with remimazolam 0.3mg/kg in R group and etomidate 0.3mg/kg in E group.Sufentanil 0.3 g/kg,rocuronium 0.6mg/kg and lidocaine lmg/kg were used in both groups.Tracheal intubation was performed after muscle relaxation was completed.There were six time points immediately before anesthesia induction(T0),BIS<60(T1),before endotracheal intubation(T2),immediately after endotracheal intubation(T3),1min after endotracheal intubation(T4)and 5min after endotracheal intubation(T5).The adverse reactions such as BIS,mean arterial pressure(MAP),heart rate(HR),cardiac output(CO),cardiac index(CI),stroke volume(SV),stroke index(SVI)and Loc time,dosage and times of vasoactive drugs,arrhythmia,intraoperative awareness,severe cardiovascular complications within 24 hours after operation,postoperative nausea and vomiting and postoperative muscle pain were recorded.Results 1.Compared with T0,BIS,SBP,DBP,MAP,CO,CI,SV and SVI decreased in group R and E group at T1,T2,T3,T4 and T5(P<0.05).Compared with T0,HR in group R increased at T1(P<0.05),but there was no significant difference in HR in group E(P>0.05).Compared with T0,HR decreased in both groups at T2(P<0.05).Compared with T0,HR increased in both groups at T3,T4 and T5(P<0.05).2.Compared with group E,there was no significant difference in general condition,dosage of induction drugs,rescue sedation rate,incidence of arrhythmia,use of vasoactive drugs,intraoperative awareness,postoperative severe cardiovascular complications,postoperative nausea and vomiting in group R(P>0.05).The incidence of injection pain,myoclonus and postoperative muscle pain decreased in group R(P<0.05).The time of Loc increased in group R(P<0.05).There was no significant difference in BIS,HR,SBP,DBP,MAP,CO,CI,SV and SVI at T0,T1,T4 and T5(P>0.05),but HR increased at T2(P<0.05),SBP and CO increased at T3(P<0.05).Conclusion In the induction of general anesthesia in elderly patients,the effect of remimazolam tosilate on circulatory function is similar to that of etomidate,but the incidence of side effects such as injection pain and myoclonus is lower,and more advantageous.