Remimazolam benzenesulfonate anesthesia effectiveness in cardiac surgery patients under general anesthesia

Table 1 Comparison of the baseline conditions between the two groups

Baseline	Remimazolam group (n = 40)	Propofol group (n = 40)	t/χ2 value	P value
Age (yr)	54.9 ± 8.5	52.7 ± 7.0	1.264	0.210
BMI (kg/m2)	24.1 ± 2.4	23.9 ± 2.2	0.389	0.699
Systolic blood pressure (mmHg)	126.3 ± 6.3	124.8 ± 8.1	0.925	0.358
Diastolic blood pressure (mmHg)	75.7 ± 6.0	76.5 ± 7.3	-0.535	0.594
Heart rate (times/min)	76.7 ± 7.1	78.2 ± 7.7	-0.906	0.368
Blood glucose (mmol/L)	5.39 ± 0.51	5.50 ± 0.48	-0.993	0.324
Gender, n (%)			1.270	0.260
Male	25 (62.50)	20 (50.00)
Female	15 (37.50)	20 (50.00)
ASA grades, n (%)			1.868	0.393
Grade I	8 (20.00)	6 (15.00)
Grade II	20 (50.00)	26 (65.00)
Grade III	12 (30.00)	8 (20.00)

ASA: American Society of Anesthesiologists; BMI: Body mass index.

Table 2 Comparison of the hemodynamic parameter between the two groups (mean ± SD)

Indicators	T0	T1	T2	T3
HR (times/min)
Remimazolam group (n = 40)	76.7 ± 7.1	68.3 ± 6.5	66.8 ± 5.9	78.8 ± 6.6
Propofol group (n = 40)	78.2 ± 7.7	66.7 ± 6.7	65.1 ± 6.0	80.5 ± 7.3
t value	-0.906	1.091	1.278	-1.093
P value	0.368	0.279	0.205	0.278
MAP (mmHg)
Remimazolam group (n = 40)	98.4 ± 5.3	88.3 ± 4.7	86.7 ± 4.2	102.1 ± 4.8
Propofol group (n = 40)	99.6 ± 4.7	86.0 ± 4.4	83.8 ± 4.5	103.8 ± 4.2
t value	-1.071	2.259	2.980	-1.686
P value	0.287	0.027	0.004	0.096
CI (L/min·m2)
Remimazolam group (n = 40)	3.67 ± 0.62	3.52 ± 0.52	3.58 ± 0.48	3.57 ± 0.53
Propofol group (n = 40)	3.80 ± 0.60	3.40 ± 0.48	3.51 ± 0.50	3.65 ± 0.49
t value	-0.953	1.072	0.639	-0.701
P value	0.344	0.287	0.525	0.485
SVI (mL/m2·bpm)
Remimazolam group (n = 40)	47.83 ± 5.81	43.80 ± 5.26	41.94 ± 5.57	45.80 ± 5.16
Propofol group (n = 40)	49.20 ± 5.63	40.38 ± 4.95	38.53 ± 4.86	43.73 ± 5.57
t value	-1.071	2.995	2.918	1.724
P value	0.287	0.004	0.005	0.089

CI: Cardiac index; HR: Heart rate; MAP: Mean arterial pressure; SVI: Volume per wave index; T0: Pre-anesthesia induction; T1: After endotracheal intubation; T2: When the sternum was cut off; T3: When the machine was shut down.

Table 3 Comparison of oxygenation index and respiratory index between the two groups (mean ± SD)

Indicators	T1	T2	T3
OI (mmHg)
Remimazolam group (n = 40)	398.6 ± 24.7	357.6 ± 28.0	381.8 ± 30.0
Propofol group (n = 40)	390.1 ± 26.3	338.1 ± 30.5	359.4 ± 33.8
t value	1.490	2.979	3.135
P value	0.140	0.004	0.002
RI
Remimazolam group (n = 40)	0.59 ± 0.17	0.90 ± 0.23	0.50 ± 0.18
Propofol group (n = 40)	0.62 ± 0.17	0.94 ± 0.21	0.56 ± 0.20
t value	-0.789	-0.812	-1.410
P value	0.432	0.419	0.162

OI: Oxygenation index; RI: Respiratory index; T1: After endotracheal intubation; T2: When the sternum was cut off; T3: When the machine was shut down.

Table 4 Comparison of the serum levels of inflammatory factors between the two groups (mean ± SD)

Groups	Remimazolam group (n = 40)	Propofol group (n = 40)	t value	P value
TNF-α (pg/mL)
Before surgery	1.63 ± 0.46	1.80 ± 0.50	-1.583	0.118
12 h after surgery	3.74 ± 0.95	3.98 ± 1.03	-1.083	0.282
IL-6 (pg/mL)
Before surgery	54.83 ± 12.30	50.11 ± 10.86	1.819	0.073
12 h after surgery	87.55 ± 15.40	93.28 ± 14.81	-1.696	0.094
E (pg/μL)
Before surgery	1.58 ± 0.38	1.49 ± 0.40	1.032	0.305
12 h after surgery	2.52 ± 0.70	2.86 ± 0.76	-2.081	0.041
NE (pg/μL)
Before surgery	2.66 ± 0.48	2.48 ± 0.51	1.625	0.108
12 h after surgery	3.38 ± 0.75	3.73 ± 0.88	-1.914	0.059
COR (ng/mL)
Before surgery	22.73 ± 4.81	21.40 ± 4.36	1.296	0.199
12 h after surgery	34.20 ± 6.85	31.06 ± 5.72	2.225	0.029
GLU (mmol/L)
Before surgery	5.39 ± 0.51	5.50 ± 0.48	-0.993	0.324
12 h after surgery	6.18 ± 0.62	6.54 ± 0.75	-2.34	0.022

COR: Cortisol; E: Epinephrine; GLU: Glucose; IL-6: Interleukin-6; NE: Norepinephrine; TNF-α: Tumor necrosis factor alpha.

Table 5 Comparison of the perioperative indicators between the two groups (mean ± SD)

Indicators	Remimazolam group (n = 40)	Propofol group (n = 40)	t value	P value
Operative time (min)	249.6 ± 18.5	245.8 ± 17.0	0.957	0.342
Operative blood loss (mL)	308.4 ± 20.7	304.1 ± 18.6	0.977	0.331
Intraoperative urine volume (mL)	488.3 ± 81.0	502.7 ± 86.5	-0.769	0.444
CPB transit time (min)	115.8 ± 9.8	113.5 ± 10.6	1.008	0.317
Ascending aorta occlusion time (min)	76.4 ± 5.1	78.1 ± 6.3	-1.326	0.189
Recovery time (min)	121.1 ± 18.0	140.2 ± 21.5	-4.308	0.000
Extubation time (min)	158.3 ± 24.7	174.9 ± 28.6	-2.778	0.007
Fluid volume (mL)	1985.6 ± 223.1	2056.7 ± 245.7	-1.355	0.179
Fentanyl dosage (mg)	122.8 ± 21.6	126.4 ± 34.2	-0.563	0.575

CPB: Cardiopulmonary bypass.

Table 6 Comparison of the adverse reactions between the two groups, n (%)

Groups	n	Nausea	Emesis	Hypotension	Drowsiness	Uroschesis	Incidence of adverse reactions
Remimazolam group	40	1	0	1	1	1	4 (10.00)
Propofol group	40	3	1	3	3	2	12 (30.00)
χ2 value							5.000
P value							0.025