A Randomized Double-blind Study Of The Effects Of Propofol、Ciprofol And Remimazolam On Hemodynamics And Quality Of Recovery In Elderly Patients With Colorectal Cacer

Objective: To observe the effects of ciprofol and remimazolam on hemodynamics and recovery quality of elderly patients undergoing radical resection of colorectal cancer during perianaesthesia.Methods: A total of 135 patients aged 65-75 years with ASA Ⅱ-Ⅲ grade who underwent elective open surgery for direct colon cancer were selected.According to the simple randomized control method,the patients were divided into propofol group(group P),ciprofol group(group H)and remimazolam group(group R),with 45 cases in each group(n=45).Induction: Sufentanil was slowly pushed 0.3 μ g/kg in all three groups.Group P was intravenously injected with propofol 2mg/kg,group H with ciprofol 0.3mg/kg,and group R with remimazolam 0.3mg/kg;Rocuronium bromide 0.6mg/kg was used as the muscle relaxant in all three groups.Maintenance:Remifentanil was pumped at 0.1-0.2μg/kg/min in all three groups,propofol was injected intravenously at 4-10mg/kg/h in group P,ciprofol was injected intravenously at 0.8-1.2mg/kg/h in group h,and remimazolam was injected intravenously at 0.5-1.5mg/kg/h in group R.Intraoperative drug infusion speed is adjusted according to the depth of anesthesia.Mean arterial pressure(MAP),heart rate(HR),cardiac output(CO),and peripheral vascular resistance(SVR)were recorded at home invasion(T0),BIS value less than 60 after induction(T1),immediately after intubation(T2),incision(T3),60 minutes after anesthesia maintenance(T4),at the end of surgery(T5),and immediately after extubation(T6).Blood glucose levels and lactic acid values were recorded at T0,T2,T4 and T6 time points.Adverse events such as hypertension,hypotension,tachycardia,bradycardia and respiratory depression were recorded from the end of surgery to the end of PACU.The quality of recovery was recorded,including Ramsay sedation score at extubation,time from the end of surgery to extubation,PACU residence time,orientation recovery time,PONV and chill incidence.Results: Intragroup comparison of hemodynamic indexes: compared with T0 time point at T1,MAP,HR,CO and SVR in group P and group H were decreased,the difference was statistically significant(P < 0.05);compared with T0 time point at T3-T6 time point,SVR in group P and group H were decreased,the difference was statistically significant(P < 0.05);Comparison between groups: At T2 time point,MAP,HR and SVR of group H and group R were significantly higher than those of group P,and at T6 time point,MAP,CO and SVR of group R were significantly higher than those of group H and group P,with statistical significance(P < 0.05).Comparison of blood glucose and lactic acid levels: The blood glucose of group H and group P at T2 and T4 was higher than that at T0,and the difference was statistically significant(P < 0.01).Comparison of recovery quality: The incidence of adverse events such as hypotension and respiratory depression from the end of operation to the departure of PACU in group R and group H was significantly lower than that in group P,the difference was statistically significant(P < 0.01);the time from the end of operation to extubation in group R was significantly shorter than that in group P and group H,the difference was statistically significant(P < 0.01).Conclusions:The hemodynamics of elderly patients with colorectal cancer under remimazolam and ciprofol anesthesia were more stable and the incidence of postoperative adverse reactions was lower,and the postoperative recovery time of elderly patients with colorectal cancer under remimazolam anesthesia was shorter.