Effect of Remimazolam on the postoperative recovery quality of patients undergoing unilateral biportal endoscopic lumbar interbody fusion
Objective To investigate the effect of Remimazolam on the postoperative recovery quality of patients undergoing unilateral bilateral endoscopic lumbar interbody fusion.Methods A total of 126 patients who underwent unilateral bilateral endoscopic lumbar interbody fusion in Affiliated Hospital of Jiangsu University from December 2022 to October 2023 were selected,and they were divided into Propofol group and Remimazolam group according to random number table method,with 63 cases in each group.Propofol was used for induction and maintenance of general anesthesia in Propofol group,and Remimazolam was used for induction and maintenance of general anesthesia in Remimazolam group.Quality of recovery-15(QoR-15)score was compared between the two groups one day before surgery,one day after surgery,and three days after surgery;operation time,intraoperative fluid volume,blood loss,urine volume and the dosage of Sufentanil,Rocuronium,and Remifentanil were compared between the two groups;heart rate(HR),oxyhemoglobin saturation(SpO2),and mean arterial pressure(MAP)of the two groups were compared one minute before general anesthesia induction(T0),one minute after induction(T1),one minute after intubation(T2),one minute after surgery(T3),and at the time of internal fixation implantation(T4);the extubation time,postanesthesia care unit(PACU)residence time,and postoperative hospital stay were compared between the two groups;Richmond agitation sedation score(RASS)five minute after extubation was compared between the two groups;postoperative visual analogue scale(VAS)score was compared between the two groups;and the incidence of complications such as nausea,vomiting,hypoxemia,and hypotension one day after surgery,and pulmonary infection seven day after surgery were compared between the two groups.Results There were no significant differences in operation time,intraoperative fluid volume,blood loss,urine volume and the dosage of Sufentanil,Rocuronium,and Remifentanil between the two groups(P＞0.05).HR at T1 of the two groups was lower than T0,when T2 was higher than T0-T1;when T3 was lower than T0 and T2;when T4 was higher than T1,T3,while lower than T2(P＜0.05).There were no significant differences in HR between the two groups at each time point(P＞0.05).There was no significant difference in SpO2 at each time points within the two groups(P＞0.05).There was no significant difference in SpO2 between the two groups at each time points(P＞0.05).MAP at T1 of the two groups was lower than that of T0;when T2 was higher than T1;when T3 was lower than T0-T2;when T4 was lower than that of T0-T2,while higher than T3(P＜0.05).MAP at T3-T4 of Remimazolam group was higher than that of Propofol group(P＜0.05).The extubation time and PACU resident time in Remimazolam group were shorter than those in Propofol group(P＜0.05).There were no significant differences in postoperative,hospital stay,RASS,and VAS scores between the two groups(P＞0.05).There were no significant differences in the incidence of nausea,vomiting,hypoxemia,hypotension,and pulmonary infection between the two groups(P＞0.05).There were significant differences in QoR-15 scores between the two groups at each time points within the two groups(P＜0.05).QoR-15 scores of Remimazolam group was higher than that of Propofol group at one and three days after surgery(P＜0.05).Conclusion Remimazolam can improve the postoperative recovery quality for patients undergoing unilateral bilateral endoscopic lumbar interbody fusion.
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