Effect of remimazolam and propofol on postoperative delirium in elderly patients undergoing cerebral endovascular surgery

doi:10.3969/j.issn.1006-7795.2024.06.012

Abstract

Abstract: Objective To compare the effects of remimazolam and propofol on postoperative delirium （POD） in elderly patients undergoing cerebral endovascular surgery. Methods A controlled clinical trial was conducted on patients who underwent cerebral endovascular surgery in Beijing Chaoyang Hospital, Capital Medical University from June 2023 to April 2024. The patients were divided into remimazolam group (group R) and propofol group (group P). A total of 106 patients were included, with 53 in each group. The primary outcome was the incidence of POD from 30 min to 7 days after extubation between the two groups. The secondary outcomes included the time to recovery from anesthesia, the incidence of delayed extubation, the incidence of cardiovascular adverse events, the use of vasoactive drugs and the antagonist flumazenil, and the Quality of Recovery-15 (QoR-15) questionnaire at 48 h after surgery. Results A total of 103 patients (51 in group R and 52 in group P) finally completed in the study. There was no statistical difference in the incidence of POD (5.88% vs 3.85%) between the two groups within 7 days after surgery (P >0.05). The incidence of intraoperative hypotension and bradycardia was significantly lower in group R (19.60%, 9.80%) than in group P (53.85%, 25.00%) (P =0.001 3，P =0.042). Compared with that in group P, the number of cases using norepinephrine and ephedrine, in group R was significantly lower (P =0.020, P =0.033). There was no statistical difference in the time to recovery from anesthesia and dose not increase the dosage of flumazenil antagonists between the two groups (P >0.05). There was no statistical difference in QoR-15 at 48 h after surgery between the two groups (P >0.05). Conclusions The anesthetization with remimazolam show more stable hemodynamics dose not prolong the time to recovery from anesthesia and does not increase the incidence of POD in elderly patients undergoing cerebral endovascular surgery.

Key words: remimazolam, cerebral endovascular surgery, postoperative delirium (POD)

CLC Number:

R743.3

Liu Yang, Gao Chao, Wang Xiaojie, Zhang Liang, Wu Anshi. Effect of remimazolam and propofol on postoperative delirium in elderly patients undergoing cerebral endovascular surgery[J]. Journal of Capital Medical University, 2024, 45(6): 1023-1028.

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