Remimazolam versus propofol on quality of recovery after general anesthesia in elders undergoing ocular fundus daytime surgery.

Objective To compare the effects of remimazolam vs propofol on the quality of recovery in elderly patients undergoing fundus daytime surgery after general anesthesia. Methods A total of 110 elderly patients undergoing day-time fundus surgery under laryngeal mask anesthesia were randomly divided into Remimazolam group and Propofol group. Patients in Remimazolam group were induced by remimazolam, sufentanil and rocuronium, and maintained by remimazolam and remifentanil. Patients in Propofol group were induced by propofol, sufentanil and rocuronium, and maintained by propofol and remifentanil. The level of sedation was monitored by bispectral index. After surgery, patients were antagonized by flumazenil in Remimazolam group but not in propfolgroup. The quality of patients' recovery was recorded before operation and three days after operation measured by quality of recovery-15 (QoR-15) scale. Intraoperative hemodynamic data, the time to consciousness loss during induction and awakening after operation, the time for laryngeal mask removal and the incidence of adverse events after admission to post anesthesia care unit were also recorded. Results The QoR-15 score in Remimazolam group 24 hours after operation was non-inferior to that in propofol group (133.3 ±11.1 vs. 135.0±10.3; mean difference (95% CI) 1.7 (-3.9, 7.2); approving for non-inferiority). There was no significant difference in QoR-15 scores between the two groups before operation or any other setting points. Compared with Propofol group, the time to consciousness loss during induction was prolonged, and the time for awakening after operation and laryngeal mask removal were shortened in Remimazolam group (all P < 0.05). Compared with Propofol group, the hemodynamics of patients in Remimazolam group was more stable (P < 0.05). There was no significant difference in the total dosage of remifentanil, fluid, or in the incidence of adverse reactions in PACU between the two groups (P > 0.05). Conclusion In elderly patients undergoing day-time fundus surgery, induction and maintenance of anesthesia with Remimazolam could achieve the similar quality of postoperative recovery with propofol. Compared with propofol, remimazolam provide more stable hemodynamics and shorter recovery time and extubated time, contributing to higher efficiency in recovery period. [ABSTRACT FROM AUTHOR]