Effect of Intravenous Anesthesia With Remimazolam Besylate on Hemodynamics and Neuroprotection in Patients Undergoing Surgery for Craniocerebral Injury

Abstract

AIM: This study aimed to investigate the effect of intravenous anesthesia with remimazolam besylate on hemodynamics and neuroprotection in patients undergoing surgery for craniocerebral injury.

METHODS: This retrospective study analyzed the clinical data from 92 patients with craniocerebral injury who underwent craniotomy at Peking University International Hospital between May 2021 and August 2023. Based on anesthesia method applied, patients were divided into the observation group (n = 49) and the conventional group (n = 43). The conventional group underwent conventional anesthesia, and the observation group received intravenous anesthesia with remimazolam besylate. All patients were followed up for 3 months after surgery. Furthermore, perioperative hemodynamic indicators and neurological function were compared between the two groups at different time points, such as T0 (before surgery), T1 (30 minutes after anesthesia), T2 (at the end of surgery), and T3 (24 hours post-surgery). Additionally, perioperative indicators, postoperative adverse reactions, and prognosis were statistically analyzed.

RESULTS: From T0 to T1, heart rate (HR), peripheral capillary oxygen saturation (SpO₂), and mean arterial pressure (MAP) showed an increasing trend in both groups. Afterwards, HR and MAP demonstrated a decreasing trend in both groups, and ultimately restoring to T0 level. However, SpO₂ remained stable and then decreased slightly. The differences in HR, SpO₂, and MAP levels between the two groups and across different time points were statistically significant (p < 0.05). At T3, the levels of Tau protein, neuron-specific enolase, and glial fibrillary acidic protein were lower in the observation group than in the conventional group (p < 0.05). Furthermore, the observation group demonstrated shorter spontaneous breathing recovery time, eye-opening time, orientation recovery time, extubation time, length of intensive care unit (ICU) stays, and total hospital stay than the conventional group (p < 0.05). Additionally, the incidence rates of arrhythmia and pulmonary infection were lower in the observation group than in the conventional group (p < 0.05). Similarly, the observation group exhibited a better overall prognosis than the conventional group (p < 0.05).

CONCLUSIONS: Intravenous anesthesia with remimazolam besylate in patients undergoing surgery for craniocerebral injury can maintain stable hemodynamics, protect neurological function, and promote post-surgery recovery.