Comparison of remimazolam tosylate and propofol in hemodynamic stability, postoperative cognitive function, and recovery in general anesthesia combined with regional nerve blocks: a retrospective cohort study
Bibliographic record
Abstract
BACKGROUND: General anesthesia (GA) combined with regional anesthesia (RA) is commonly used to enhance perioperative analgesia and hemodynamic stability. This study aimed to compare the hemodynamic effects and postoperative cognitive function between remimazolam tosylate and propofol in patients undergoing GA combined with RA. METHODS: A retrospective cohort study was conducted on 4408 patients who underwent elective upper or lower limb surgeries at our institution from January 2020 to June 2024. Patients were divided into two groups: Remimazolam (n = 2391) and Propofol (n = 2017). The primary outcomes included hemodynamic parameters (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], mean arterial pressure [MAP]) and postoperative cognitive function (Montreal Cognitive Assessment [MoCA] scores at 24, 48, and 72 h). Secondary outcomes included anesthetic drug consumption, adverse events, and recovery times. RESULTS: The Remimazolam group was associated with more stable hemodynamic parameters, with significantly higher SBP (121.4 ± 8.3 vs. 112.6 ± 9.2 mmHg, p < 0.05), DBP (72.3 ± 6.1 vs. 67.8 ± 5.9 mmHg, p < 0.05), and MAP (88.3 ± 7.4 vs. 83.1 ± 7.2 mmHg, p < 0.05) compared to the Propofol group. Postoperative cognitive function was superior in the Remimazolam group, with higher MoCA scores at 24, 48, and 72 h (19.6 ± 2.1 vs. 16.3 ± 3.4 at 24 h, p < 0.05). The Remimazolam group also had lower anesthetic consumption (0.16 ± 0.02 vs. 2.4 ± 0.3 mg/kg, p < 0.05), faster recovery times (extubation 8.4 ± 2.1 vs. 11.2 ± 3.4 min, p < 0.05), and fewer adverse events (hypotension: 14% vs. 28%, p < 0.05). CONCLUSION: Remimazolam tosylate was associated with more stable hemodynamic parameters, lower rates of postoperative cognitive dysfunction, and shorter recovery times compared to propofol in patients undergoing GA combined with RA, suggesting it may be a safer alternative for patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".