Objective: To investigate the comparison between remimazolam and ciprofol on post-induction hypotension (PIH) in elderly patients.
Methods: Sixty-two elderly patients undergoing inguinal hernia repair, 58 males, 4 females, aged 65-85 years, BMI 18.5-30.0 kg/m 2, ASA physical status Ⅱ or Ⅲ. The patients were randomly assigned to two groups: the remimazolam group (group R) and the ciprofol group (group C), 31 patients in each group. During anesthesia induction, group R received a continuous infusion of remimazolam at 3 mg·kg-1·h-1, while group C received a continuous infusion of ciprofol at 6 mg·kg-1·h-1. The incidence of PIH, minimum MAP, successful induction rate, sedative drug dosage, induction time, and recovery time were recorded. HR and MAP were recorded before induction, immediately after loss of consciousness, immediately after intubation, 5 minutes after intubation, and immediately after skin incision. Adverse events such as hypertension, tachycardia, bradycardia, respiratory depression, injection pain, and hiccups were also recorded.
Results: Compared with group C, the incidence of PIH was significantly lower in group R (P < 0.05), and the minimum MAP was significantly higher in group R (P < 0.05). The induction success rate was 100% in both groups. The cumulative sedative drug doses during induction were 0.16 mg/kg for remimazolam and 0.29 mg/kg for ciprofol, with no statistically significant difference in induction time between the two groups, group R had a significantly longer recovery time than group C (P < 0.05). HR was significantly increased immediately after intubation and 5 minutes after intubation in group R, and MAP was significantly higher immediately after intubation (P < 0.05). There were no statistically significant differences between the two groups in the incidence of hypertension, tachycardia, bradycardia, and respiratory depression. Neither group experienced injection pain, hiccups, postoperative delirium, or intraoperative awareness.
Conclusion: Both induction strategies effectively achieved anesthesia induction in elderly surgical patients. Continuous infusion of remimazolam at 3 mg·kg-1·h-1 significantly reduced the incidence of PIH, maintained hemodynamic stability in elderly patients, and did not cause severe adverse reactions, demonstrating significant clinical application value. |
