Volume 23 Issue 1
Jan.  2025
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Article Navigation >  Chinese Journal of General Practice  > 2025  >  23(1): 77-80
HUANG Changjun, XIE Xiuxiu, GUO Shaohui, SHI Siren. Analysis of the influence of remazolam on delirium risk in elderly surgical patients[J]. Chinese Journal of General Practice, 2025, 23(1): 77-80. doi: 10.16766/j.cnki.issn.1674-4152.003839
Citation: HUANG Changjun, XIE Xiuxiu, GUO Shaohui, SHI Siren. Analysis of the influence of remazolam on delirium risk in elderly surgical patients[J]. Chinese Journal of General Practice, 2025, 23(1): 77-80. doi: 10.16766/j.cnki.issn.1674-4152.003839
shu

Analysis of the influence of remazolam on delirium risk in elderly surgical patients

doi: 10.16766/j.cnki.issn.1674-4152.003839
  • 1.

    Department of Anesthesiology, the First People' s Hospital of Linping District, Hangzhou, Zhejiang 311100, China

Funds:

 2024KY270

 B20231551

  • Received Date: 2024-03-16
    Available Online: 2025-02-13
    Abstract
  •   Objective   Elderly patients undergoing hip replacement surgery are at high risk of postoperative delirium. The rational selection of anesthetic drugs is crucial to reducing this risk. A new type of ultra-short-acting benzodiazepine intravenous sedative, remazolam, offers advantages such as quick onset, rapid recovery, and no accumulation, making it a great application for elderly patients. This study investigates the effect of remazolam on the risk of postoperative delirium in elderly patients undergoing hip replacement surgery.   Methods   From July 2021 to May 2023, 100 elderly patients scheduled for surgical treatment at the First People' s Hospital of Linping District, Hangzhou, were included as the research object. Patients were divided into the propofol group and the remazolam group by simple randomization method, with 50 cases in each group. The propofol group was given propofol anesthesia induction and intraoperative anesthesia maintenance, while the remazolam group was given remazolam anesthesia induction and intraoperative anesthesia maintenance. The use of vasoactive drugs in the operation between the two groups was recorded. The quality of postoperative recovery and the incidence of postoperative delirium were compared between the two groups.   Results   Neither group required nicardipine during surgery. However, the dosage of dopamine, norepinephrine, atropine, and ephedrine during operation in the remazolam group was lower than those in the propofol group (P < 0.05). There was no statistical difference in QoR-40 scores between the two groups on immediately after anesthesia, 1st postoperative day, and 3rd postoperative day (Waldχ2=0.887, P=0.346). The incidence of delirium in the propofol group was 26.00% (13/50)immediately after anesthesia, 6.00% (3/50) on the first postoperative day, and 2.00% (1/50) on the third postoperative day. In the remazolam group, the incidence was 14.00% (7/50), 4.00% (2/50), and 4.00% (2/50), respectively, with no statistical difference between the two groups (Waldχ2=1.818, P=0.178).   Conclusion   Remazolam effectively reduces the dosage of vasoactive drugs in elderly patients undergoing surgery. However, its effects on postoperative recovery quality and postoperative delirium risk are comparable to those of propofol.

     

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    • References(21)
  • [1]
    中国老年医学学会麻醉学分会. 中国老年患者术后谵妄防治专家共识[J]. 国际麻醉学与复苏杂志, 2023, 44(1): 1-27.

    Anesthesiology Branch of the Chinese Geriatrics Society. Expert consensus on prevention and treatment of postoperative delirium in elderly patients in China[J]. International Journal of Anesthesiology and Resuscitation, 2023, 44(1): 1-27.
    [2]
    徐云云, 鲁娟, 黄聪聪, 等. 股骨头坏死全髋置换术后谵妄综合征情况调查及影响因素分析[J]. 中华全科医学, 2023, 21(8): 1425-1428, 1436. doi: 10.16766/j.cnki.issn.1674-4152.003137

    XU Y Y, LU J, HUANG C C, et al. Investigation of delirium syndrome after total hip arthroplasty for femoral head necrosis and analysis of influencing factors[J]. Chinese Journal of General Practice, 2023, 21(8): 1425-1428, 1436. doi: 10.16766/j.cnki.issn.1674-4152.003137
    [3]
    HU Q, LIU X, WEN C, et al. Remimazolam: an updated review of a new sedative and anaesthetic[J]. Drug Des Devel Ther, 2022, 16(1): 3957-3974.
    [4]
    LIU T, LAI T, CHEN J, et al. Effect of remimazolam induction on hemodynamics in patients undergoing valve replacement surgery: a randomized, double-blind, controlled trial[J]. Pharmacol Res Perspect, 2021, 9(5): e00851. DOI: 10.1002/prp2.851.
    [5]
    BAEK W, LEE J, JANG Y, et al. Assessment of risk factors for postoperative delirium in older adults who underwent spinal surgery and identifying associated biomarkers using exosomal protein[J]. J Korean Acad Nurs, 2023, 53(4): 371-384. doi: 10.4040/jkan.22146
    [6]
    BALLWEG T, WHITE M, PARKER M, et al. Association between plasma tau and postoperative delirium incidence and severity: a prospective observational study[J]. Br J Anaesth, 2021, 126(2): 458-466. doi: 10.1016/j.bja.2020.08.061
    [7]
    李梦慈, 杨晓倩, 朱开润, 等. 艾司氯胺酮对甲状腺手术患者术后恢复质量及情绪状态的影响[J]. 实用药物与临床, 2023, 26(2): 127-131.

    LI M C, YANG X Q, ZHU K R, et al. Effects of esketamine on the quality of postoperative recovery and emotional state of patients undergoing thyroid surgery[J]. Practical Pharmacy and Clinical Remedies, 2023, 26(2): 127-131.
    [8]
    ABEN J, POUWELS S, OLDENBEUVING A. Comparison between deltascan single channel electroencephalography (EEG), confusion assessment method-intensive care unit (CAM-ICU) score and clinical assessment in diagnosing delirium in intubated patients in the intensive care unit[J]. Cureus, 2022, 14(6): e26449. DOI: 10.7759/cureus.26449.
    [9]
    BURNETT G W, TAREE A, MARTIN L, et al. Propofol misuse in medical professions: a scoping review[J]. Can J Anaesth, 2023, 70(3): 395-405. doi: 10.1007/s12630-022-02382-2
    [10]
    LEE A, SHIRLEY M. Remimazolam: A review in procedural sedation[J]. Drugs, 2021, 81(10): 1193-1201. doi: 10.1007/s40265-021-01544-8
    [11]
    CHERNOVA A P, SHORMANOV V K, DAVYDKINA A E. Propofol: use, toxicology and assay features[J]. Sud Med Ekspert, 2022, 65(5): 46-51. doi: 10.17116/sudmed20226505146
    [12]
    DOIM, HIRATA N, SUZUKI T, et al. Safety and efficacy of remimazolam in induction and maintenance of general anesthesia in high-risk surgical patients (ASA Class Ⅲ): results of a multicenter, randomized, double-blind, parallel-group comparative trial[J]. J Anesth, 2020, 34(4): 491-501.
    [13]
    QIU Y, GU W, ZHAO M, et al. The hemodynamic stability of remimazolam compared with propofol in patients undergoing endoscopic submucosal dissection: a randomized trial[J]. Front Med (Lausanne), 2022, 9(1): 938940. DOI: 10.3389/fmed.2022.938940.
    [14]
    WESSELS E, PERRIE H, SCRIBANTE J, et al. Quality of recovery in the perioperative setting: a narrative review[J]. J Clin Anesth, 2022, 78: 110685. DOI: 10.1016/j.jclinane.2022.110685.
    [15]
    MAO Y, GUO J, YUAN J, et al. Quality of recovery after general anesthesia with remimazolam in patients' undergoing urologic surgery: a randomized controlled trial comparing remimazolam with propofol[J]. Drug Des Devel Ther, 2022, 16(1): 1199-1209.
    [16]
    TAN Y, OUYANG W, TANG Y, et al. Effect of remimazolam tosilate on early cognitive function in elderly patients undergoing upper gastrointestinal endoscopy[J]. J Gastroenterol Hepatol, 2022, 37(3): 576-583.
    [17]
    JIN N, XUE Z. Benefits of remimazolam as an anesthetic sedative for older patients: a review[J]. Heliyon, 2024, 10(4): e25399. DOI: 10.1016/j.heliyon.2024.e25399.
    [18]
    SNEYD J R, RIGBY-JONES A E. Remimazolam for anaesthesia or sedation[J]. Curr Opin Anaesthesiol, 2020, 33(4): 506-511.
    [19]
    WHITE P F. Remimazolam-can it become a cost-effective alternative to propofol for intravenous anesthesia and sedation?[J]. J Clin Anesth, 2023, 84(1): 110977. DOI: 10.1016/j.jclinane.2022.110977.
    [20]
    OKA S, SATOMI H, SEKINO R, et al. Sedation outcomes for remimazolam, a new benzodiazepine[J]. J Oral Sci, 2021, 63(3): 209-211.
    [21]
    YANG J J, LEI L, QIU D, et al. Effect of remimazolam on postoperative delirium in older adult patients undergoing orthopedic surgery: a prospective randomized controlled clinical trial[J]. Drug Des Devel Ther, 2023, 17(1): 143-153.
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