Remimazolam Supplemented to General Anesthesia Alleviates Stress and Cognitive Impairment in Elder Patients After Hip Surgery

Objective Stress and cognitive impairment are common postoperative complications in elder patients who have undergone hip sur-gery. The objective of the work is to evaluate the effects of remimazolam supplemented to combined general anesthesia in improving stress and cognitive performance.Methods A total of 120 patients were included to receive a low dose of remimazolam (0.1 mg/kg/h) intravenously combined with gener-al anesthesia or general anesthesia alone during hip surgery. Assessments were used for evaluating cognitive and psychological perfor-mance respectively before surgery (T0), 24 h (T5), and 72 h (T6) after surgery. Physiological parameters including mean artery pressure, heart rate, and blood oxygen levels (SpO2) were measured at T0, 30 min after anesthesia (T1), and completion of surgery (T2). Stress index-es including serum cortisol and norepinephrine levels were measured at T0, T5, and T6. The visual analog scale pain scores were also acquired at 6 h after surgery, 12 h after surgery, and T6. Serum interleukin-6 and tumor necrosis factor-alpha levels were acquired at T0, T2, and T6.Results Heart rate and SpO2 levels in the combination group were significantly improved compared to the control group. Serum corti-sol and norepinephrine levels were the highest at T1 and decline over time until T5 in both groups, the two stress indexes of the combi-nation group were significantly lower at T1 and T2.Conclusion Remimazolam supplemented to combined general anesthesia demonstrated significant benefit in reducing stress and cog-nitive dysfunction in elder patients who underwent hip surgery.