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已发表论文
瑞马唑仑-丙泊酚麻醉对老年患者腹腔镜结直肠癌手术后恢复及睡眠质量的影响：一项随机对照试验
Authors Shi P , Wang C, Tang Y, Hou J, Bian J, Bo L
Received 2 September 2025
Accepted for publication 17 December 2025
Published 30 December 2025 Volume 2025:19 Pages 11901—11910
DOI https://doi.org/10.2147/DDDT.S564187
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Yan Zhu
Peng Shi,* Chun Wang,* Yingying Tang, Jiong Hou, Jinjun Bian, Lulong Bo
Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lulong Bo, Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, 200433, People’s Republic of China, Tel +86 2131161839, Email bartbo@smmu.edu.cn Jinjun Bian, Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, 200433, People’s Republic of China, Tel +86 2131161840, Email jinjunbian@smmu.edu.cn
Purpose: Propofol and remimazolam monotherapy have their own limitations for general anesthesia in elderly patients. Optimizing anesthesia protocols is essential to enhance recovery and postoperative outcomes. This study aimed to evaluate the effects of combined sub-anesthetic doses of remimazolam and propofol on anesthesia recovery and sleep quality in this population.
Patients and Methods: This single-center, single-blind, prospective, randomized controlled trial enrolled 92 patients aged 65– 80 years scheduled for elective laparoscopic colorectal cancer surgery. Patients were randomly allocated to either group P (propofol alone, 4– 12 mg/kg/h) or group PR (propofol 2– 4 mg/kg/h combined with remimazolam 0.3 mg/kg/h). The primary outcome was awakening time. The secondary outcomes included sedation scores, intraoperative hemodynamics, postoperative Pittsburgh Sleep Quality Index (PSQI) scores, Visual Analogue Scale (VAS) scores, Quality of Recovery-15 (QoR-15) scores, and the incidence of adverse events.
Results: Awakening time was significantly reduced in group PR compared with group P (14.8 ± 4.8 min vs 18.9 ± 5.1 min, P < 0.001). Group PR showed higher QoR-15 scores at 24 h postoperatively (129 [124.3– 133] vs 121.5 [118– 128], P = 0.002), a lower incidence of sleep disturbances on postoperative days 1 and 3 (P < 0.001), and more stable intraoperative hemodynamics with a lower incidence of hypotension (19.6% vs 54.4%, P < 0.001). No significant differences were observed in VAS scores or other adverse events.
Conclusion: Anesthesia maintenance using a sub-anesthetic dose of remimazolam combined with propofol was associated with shorter awakening time and improved postoperative recovery quality. This combination may represent a promising anesthetic strategy, but further research with objective sleep monitoring is warranted to confirm these findings.
Keywords: remimazolam, propofol, anesthesia maintenance, older adult patients, anesthesia recovery, sleep quality
Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Lulong Bo, Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, 200433, People’s Republic of China, Tel +86 2131161839, Email bartbo@smmu.edu.cn Jinjun Bian, Faculty of Anesthesiology, Changhai Hospital, Naval Medical University, Shanghai, 200433, People’s Republic of China, Tel +86 2131161840, Email jinjunbian@smmu.edu.cn
Purpose: Propofol and remimazolam monotherapy have their own limitations for general anesthesia in elderly patients. Optimizing anesthesia protocols is essential to enhance recovery and postoperative outcomes. This study aimed to evaluate the effects of combined sub-anesthetic doses of remimazolam and propofol on anesthesia recovery and sleep quality in this population.
Patients and Methods: This single-center, single-blind, prospective, randomized controlled trial enrolled 92 patients aged 65– 80 years scheduled for elective laparoscopic colorectal cancer surgery. Patients were randomly allocated to either group P (propofol alone, 4– 12 mg/kg/h) or group PR (propofol 2– 4 mg/kg/h combined with remimazolam 0.3 mg/kg/h). The primary outcome was awakening time. The secondary outcomes included sedation scores, intraoperative hemodynamics, postoperative Pittsburgh Sleep Quality Index (PSQI) scores, Visual Analogue Scale (VAS) scores, Quality of Recovery-15 (QoR-15) scores, and the incidence of adverse events.
Results: Awakening time was significantly reduced in group PR compared with group P (14.8 ± 4.8 min vs 18.9 ± 5.1 min, P < 0.001). Group PR showed higher QoR-15 scores at 24 h postoperatively (129 [124.3– 133] vs 121.5 [118– 128], P = 0.002), a lower incidence of sleep disturbances on postoperative days 1 and 3 (P < 0.001), and more stable intraoperative hemodynamics with a lower incidence of hypotension (19.6% vs 54.4%, P < 0.001). No significant differences were observed in VAS scores or other adverse events.
Conclusion: Anesthesia maintenance using a sub-anesthetic dose of remimazolam combined with propofol was associated with shorter awakening time and improved postoperative recovery quality. This combination may represent a promising anesthetic strategy, but further research with objective sleep monitoring is warranted to confirm these findings.
Keywords: remimazolam, propofol, anesthesia maintenance, older adult patients, anesthesia recovery, sleep quality