Dose-Dependent Effects of Remimazolam on Early Perioperative Neurocognitive Disorders in Elderly Colorectal Cancer Patients Undergoing Laparoscopic Surgery
Bibliographic record
Abstract
Objective: To study the effect of different doses of remimazolam on the maintenance of anesthesia and its impact on postoperative cognitive function in elderly patients undergoing laparoscopic colorectal surgery. Methods: A total of 120 elderly patients scheduled for laparoscopic colorectal surgery under general anesthesia (both sexes included, ASA grade (II-III) were randomly assigned to experimental groups (R1-R3) and control group (P), with 30 cases per group. The experimental groups received different remimazolam maintenance doses: R1 (0.5 mg/kg/h), R2 (1.0 mg/kg/h), and R3 (1.5 mg/kg/h), while the control group received propofol for sedation. Perioperative cognitive function was evaluated using MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) preoperatively, and on postoperative days 3 and 7, to analyze differences in cognitive effects and safety profiles of remimazolam across the four groups. Results: A total of 117 patients were ultimately included, with 3 excluded due to intraoperative conversion to open surgery. Participants were randomly allocated into four groups according to remimazolam maintenance dosing regimens: 30 in the R1 group, 28 in the R2 group, 30 in the R3 group, and 29 in the P group.There was no statistically significant difference in postoperative cognitive function scores between the R2 and R3 groups, and both groups had scores that were significantly higher than those of the R1 and P groups, with statistically significant differences. Conclusion: Compared to propofol, remimazolam at medium and high doses can reduce the incidence of perioperative neurocognitive dysfunction in elderly patients. High-dose remimazolam anesthesia maintenance may prolong extubation time, increase the incidence of postoperative shivering, and potentially lead to re-sedation after awakening, so medium-dose remimazolam is more suitable for intraoperative anesthesia maintenance in elderly patients without increasing the incidence of adverse events.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| 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".