Abstract:

Objective To compare the effects of remimazolam and propofol on the quality of recovery in children with strabismus surgery under general anesthesia. Methods A total of 100 children scheduled for strabismus surgery were enrolled and randomly assigned to the remimazolam group (R group) or the propofol group (P group). Children in the R group received intravenous remimazolam 0.2 mg/kg, followed by remimazolam infusion at a rate of 1-3 mg·kg^-1·h^-1. Children in the P group received intravenous propofol 2.5 mg/kg, followed by propofol infusion at a rate of 4-12 mg·kg^-1·h^-1. The intraoperative hypotension, extubation time, post-anesthesia care unit (PACU) stay time, postoperative nausea and vomiting (PONV), and incidence of emergence agitation were recorded in the two groups of patients. Emergence agitation was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale. Results A total of 49 and 50 children were included in the R group and the P group, respectively. Compared with the P group, the R group showed a significant increase in mean arterial pressure and heart rate at 15 minutes after the start of surgery (P < 0.05). The incidence of intraoperative hypotension (14.3% vs. 46.0%) and emergence agitation (14.3% vs. 38.0%) were significantly lower in the R group than those in the P group (P < 0.05). The extubation time [(15.7±5.8) min vs. (11.3±4.6) min], PACU stay time [(27.5±7.3) min vs. (23.2±6.5) min] were significantly longer in the R group than those in the P group, while the highest PAED score [(7.6±2.9) vs. (9.4±3.3)] was significantly lower in the R group than that in the P group, (P < 0.05). Conclusion Compared with propofol, remimazolam can reduce the risk of emergence agitation in children undergoing strabismus surgery under general anesthesia, and has advantages in maintaining hemodynamic stability during surgery.

Key words: benzodiazepines, strabismus, emergence delirium, hemodynamics, propofol, child, remimazolam