The Effects of Remimazolam and Propofol on Hemodynamics, Bispectral Index and Postoperative Cognitive Function in Elderly Patients Undergoing Neurointerventional Operation

Qian Huang¹, Tao Hu¹, Ying Yang¹, Yuying He¹, Yingzi Ling¹, Gaoyin Kong¹ and Yi Zou^1,

¹Department of Anesthesiology, Hunan Provincial People’s Hospital, The First Affiliated Hospital of Hunan Normal University, Clinical Research Center for Anesthesiology of ERAS in Hunan Province, Changsha, China

Cite this paper

Qian Huang, Tao Hu, Ying Yang, Yuying He, Yingzi Ling, Gaoyin Kong and Yi Zou. The Effects of Remimazolam and Propofol on Hemodynamics, Bispectral Index and Postoperative Cognitive Function in Elderly Patients Undergoing Neurointerventional Operation. American Journal of Medical Case Reports. 2024; 12(2):10-14. doi: 10.12691/AJMCR-12-2-1

Abstract

Previous studies have shown that remimazolam has a lesser effect on hemodynamics and postoperative cognitive function than propofol. In this study, we recruited sixty elderly patients undergoing neurointerventional operation under remimazolam or propofol anesthesia. The results showed that in comparison with propofol, remimazolam provided more stable hemodynamics but higher bispectral index during anesthesia induction. Patients' cognitive function declined slightly after operation, but did not differ between the two anesthetic protocols.

Keywords

remimazolam, propofol, hemodynamics, bispectral index, cognitive, elderly

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Boztas N, Oztekin S, Ozkardesler S, Akan M, Ozbilgin S, Baytok A. Effects of different doses of remifentanil on hemodynamic response to anesthesia induction in healthy elderly patients. Curr Med Res Opin. 2017 Jan; 33(1): 85-90.
[2]	Liu X, Xiao Q, Zhuang S. Comparison of propofol-esketamine versus propofol for anesthesia in gastroscopy: a double-blind, randomized controlled clinical trial. Front Med (Lausanne). 2023 Aug 8; 10: 1184709.
[3]	Zhang KD, Wang LY, Zhang DX, Zhang ZH, Wang HL. Comparison of the Effectiveness of Various Drug Interventions to Prevent Etomidate-Induced Myoclonus: A Bayesian Network Meta-Analysis. Front Med (Lausanne). 2022 Apr 26; 9: 799156.
[4]	Dai G, Pei L, Duan F, Liao M, Zhang Y, Zhu M, Zhao Z, Zhang X. Safety and efficacy of remimazolam compared with propofol in induction of general anesthesia. Minerva Anestesiol. 2021 Oct; 87(10): 1073-1079.
[5]	Zhang X, Li S, Liu J. Efficacy and safety of remimazolam besylate versus propofol during hysteroscopy: single-centre randomized controlled trial. BMC Anesthesiol. 2021 May 20; 21(1): 156.
[6]	Doi M, Morita K, Takeda J, Sakamoto A, Yamakage M, Suzuki T. Efficacy and safety of remimazolam versus propofol for general anesthesia: a multicenter, single-blind, randomized, parallel-group, phase IIb/III trial. J Anesth. 2020 Aug; 34(4): 543-553.
[7]	Xu Q, Wu J, Shan W, Duan G, Lan H. Effects of remimazolam combined with sufentanil on hemodynamics during anesthetic induction in elderly patients with mild hypertension undergoing orthopedic surgery of the lower limbs: a randomized controlled trial. BMC Anesthesiol. 2023 Sep 14; 23(1): 311.
[8]	Kim TK, Kwak HJ, Jung WS, Choi GB, Park SY, Kim JY. Effects of Remimazolam Anesthesia with Two Induction Doses on Hemodynamics and Recovery Profile in Older Patients: Comparison with Propofol Anesthesia. J Clin Med. 2023 Aug 14; 12(16): 5285.
[9]	Sekiguchi R, Kinoshita M, Kawanishi R, Kakuta N, Sakai Y, Tanaka K. Comparison of hemodynamics during induction of general anesthesia with remimazolam and target-controlled propofol in middle-aged and elderly patients: a single-center, randomized, controlled trial. BMC Anesthesiol. 2023 Jan 10; 23(1): 14.
[10]	Abou-Chebl A, Yeatts SD, Yan B, Cockroft K, Goyal M, Jovin T, Khatri P, Meyers P, Spilker J, Sugg R, Wartenberg KE, Tomsick T, Broderick J, Hill MD. Impact of General Anesthesia on Safety and Outcomes in the Endovascular Arm of Interventional Management of Stroke (IMS) III Trial. Stroke. 2015 Aug; 46(8): 2142-8.
[11]	Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975 Nov; 12(3): 189-98.
[12]	Shen XC, Ao X, Cao Y, Lan L, Liu XM, Sun WJ, Li P, Lan CH. Etomidate-remifentanil is more suitable for monitored anesthesia care during gastroscopy in older patients than propofol-remifentanil. Med Sci Monit. 2015 Jan 1; 21: 1-8.
[13]	Choi BH, Lee YC. Effective Bolus Dose of Sufentanil to Attenuate Cardiovascular Responses in Laryngoscopic Double-Lumen Endobronchial Intubation. Anesth Pain Med. 2016 Apr 4; 6(2): e33640.
[14]	Gao J, Yang C, Ji Q, Li J. Effect of remimazolam versus propofol for the induction of general anesthesia on cerebral blood flow and oxygen saturation in elderly patients undergoing carotid endarterectomy. BMC Anesthesiol. 2023 May 4; 23(1): 153.
[15]	Kuang Q, Zhong N, Ye C, Zhu X, Wei F. Propofol Versus Remimazolam on Cognitive Function, Hemodynamics, and Oxygenation During One-Lung Ventilation in Older Patients Undergoing Pulmonary Lobectomy: A Randomized Controlled Trial. J Cardiothorac Vasc Anesth. 2023 Oct; 37(10): 1996-2005.
[16]	Wang L, Chen B, Liu T, Luo T, Kang W, Liu W. Risk factors for delayed neurocognitive recovery in elderly patients undergoing thoracic surgery. BMC Anesthesiol. 2023 Mar 31; 23(1): 102.