Abstract：OBJECTIVE To investigate the safety and efficacy of different doses of remimazolam combined with remifentanil in urological short operation. METHODS Seventy-five patients who underwent elective microsomia urology surgery in our hospital were divided into 3 groups according to different induced dose of anesthesia: group A: remazolam 0.2 mg·kg-1, group B: remazolam 0.3 mg·kg-1 group C: remazolam 0.4 mg·kg-1. At the same time, the bispect ral index(BIS) was recorded. When the BIS value was lower than 60, sufentanil 0.2 μg·kg-1 and Scholin 1 mg·kg-1 were injected successively in each group, and the laryngeal mask was placed 1min later. If BIS>60 after the initial dose of remimazolam, they were given 0,05 mg·kg-1 remimazolam, up to a maximum of three supplemental doses administered as IV boluses, was permitted after 1 min at the end of the initial dose. If BIS was still > 60 after 3 times of addition, the induction failure was considered, and propofol was added. Anesthesia maintenance: remimazolam was administered at a dose of 1 mg·kg-1·h-1 and adjusted as appropriate (maximum allowed infusion rate: 2 mg·kg-1·h-1) based on BIS value and monitoring of the general condition of individual subjects until the end of the surgery. Stop all medications at the end of the operation. Intraoperative observation: the success rate of induced sedation with different doses of remimazolam; the time from administration to BIS≤60 during general anesthesia induction; changes of BIS and intraoperative adverse reactions were recorded during induction and maintenance of general anesthesia; remedic sedatives during induction and maintenance of general anesthesia; recovery time; Intraoperative recall was assessed which was administered 24 h after surgery and before the patient left the recovery room. RESULTS The success rate of single induction was 76% in group A and 100% in group B and C. With the increase of induced dose, the time of BIS≤60 was shortened. The incidence of intraoperative hypotension in group A and B was 4%, and that in group C was 8%. During induction, the incidence of hypoxemia was 4% in group A and B, but 12% in group C before laryngeal mask placement. All groups successfully completed the induction and maintenance of general anesthesia, and no intraoperative awareness occurrence was observed. Postoperative recovery quality was high, and there was no significant statistical difference between the groups. CONCLUSION Remimazolam combined with remifentanil is safe, feasible and effective for anesthesia and maintenance of urological surgery. Induction dose of 0.3 mg·kg-1 and maintenance dose of 1 mg·kg-1·h-1 had little effect on hemodynamics, and the postoperative recovery quality was higher.
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