瑞马唑仑和丙泊酚全麻维持对老年患者胸腔镜肺叶切除术后肝功能和恢复质量及围术期安全性影响的比较

doi:10.3969/j.issn.1006-5725.2026.10.022

Abstract

Abstract:

Objective To compare the effects of remimazolam versus propofol for general anesthesia maintenance on postoperative liver function， quality of recovery， and perioperative safety in elderly patients undergoing video-assisted thoracoscopic lobectomy （VATS）. Methods A total of 117 patients aged ≥ 65 years scheduled for VATS lobectomy were enrolled and randomly assigned to two groups using a random number table： the propofol group （Group P， n = 59） and the remimazolam group （Group R， n = 58）. For anesthesia induction， Group P received propofol 2 mg/kg and Group R received remimazolam 0.25 mg/kg. For anesthesia maintenance， Group P received a continuous infusion of propofol at 8 mg/（kg·h）， and Group R received a continuous infusion of remimazolam at 1.2 mg/（kg·h）. Both groups were combined with target-controlled infusion （TCI） of remifentanil for analgesia. Anesthesia depth was monitored using SedLine to maintain the Patient State Index （PSI） between 25 and 50. Postoperative analgesia was provided via standardized patient-controlled intravenous analgesia （PCIA）. Patient demographics were recorded. The primary outcome was the change in alanine aminotransferase from baseline on postoperative day 1 （ΔALT）. Secondary outcomes included the changes in aspartate aminotransferase （ΔAST） and total bilirubin （ΔTBIL） from baseline on postoperative days 1 and 3， as well as the levels of ALT， AST， and TBIL assessed preoperatively and on postoperative days 1 and 3， and the Quality of Recovery-15 （QoR-15） scores at the same time points.Mean arterial pressure （MAP）， heart rate （HR）， and PSI were recorded at the following time points： before induction （T₁）， when PSI reached 50 （T₂）， during tracheal intubation （T₃）， at skin incision （T₄）， during irrigation （T₅）， during skin suturing （T₆）， and during extubation （T₇）. Postoperative extubation time， post-anesthesia care unit （PACU） stay duration， and the incidences of nausea and vomiting， hypoxemia， and hypotension within 72 hours postoperatively were recorded. Results There were no statistically significant differences in preoperative levels of ALT， AST， and TBIL between the two groups （P > 0.05）. The primary outcome， ΔALT， showed no significant difference between the groups. No significant differences were observed in ΔAST and ΔTBIL on postoperative days 1 and 3 between the two groups （all P > 0.05）. Compared with preoperative values， ALT， AST， and TBIL levels were significantly elevated on postoperative day 1 in both groups （P < 0.05）， with a gradual decrease by postoperative day 3， suggesting a transient elevation of liver function indicators induced by surgical stress. Compared with Group P， Group R had significantly higher QoR-15 scores on postoperative day 3， significantly higher MAP at T₂ and T₃， and significantly higher HR at T₃ （P < 0.05）. Postoperative extubation time and PACU stay duration were significantly shorter in Group R compared with Group P （P < 0.05）. There were no statistically significant differences between the two groups in baseline characteristics （age， sex， ASA grade， BMI）， intraoperative parameters （operation time， anesthesia time， blood loss， urine output， fluid infusion volume， remifentanil consumption）， PSI values at different time points， or the incidence of postoperative nausea and vomiting， hypoxemia， and hypotension （all P > 0.05）. Conclusions In elderly patients undergoing VATS lobectomy with potential risk of liver injury， remimazolam and propofol for general anesthesia maintenance have no significant difference in their overall impact on postoperative liver function. However， remimazolam can improve intraoperative hemodynamic stability， shorten recovery time， and enhance the quality of postoperative recovery.

Key words: remimazolam, propofol, elderly patients, video-assisted thoracoscopic lobectomy, liver function, postoperative quality of recovery

CLC Number:

R614.2

Yixin GUO,Shiya LIU,Yining CUI,Hang YI,Wentong LIU,Xihua LU. Comparison of the effects of remimazolam versus propofol for general anesthesia maintenance on postoperative liver function， quality of recovery， and perioperative safety in elderly patients undergoing video-assisted thoracoscopic lobectomy for lung cancer[J]. The Journal of Practical Medicine, 2026, 42(10): 1865-1872.

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References 33

[1]	SUNG H， FERLAY J， SIEGEL R L， et al. Global Cancer Statistics 2020： GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries ［J］. CA Cancer J Clin， 2021， 71（3）： 209-249.doi：10.3322/caac.21660 . doi: 10.3322/caac.21660
[2]	JIN Y， KANG Y， WANG M， et al. Targeting polarized phenotype of microglia via IL6/JAK2/STAT3 signaling to reduce NSCLC brain metastasis ［J］. Signal Transduct Target Ther， 2022， 7（1）： 52.doi：10.1038/s41392-022-00872-9 . doi: 10.1038/s41392-022-00872-9
[3]	SIEGEL R L， MILLER K D， JEMAL A. Cancer statistics， 2016 ［J］. CA Cancer J Clin， 2016， 66（1）： 7-30.doi：10.3322/caac.21332 . doi: 10.3322/caac.21332
[4]	QIAO Y， FENG H， ZHAO T， et al. Postoperative cognitive dysfunction after inhalational anesthesia in elderly patients undergoing major surgery： The influence of anesthetic technique， cerebral injury and systemic inflammation ［J］. BMC Anesthesiol， 2015， 15： 154.doi：10.1186/s12871-015-0130-9 . doi: 10.1186/s12871-015-0130-9
[5]	LIU X， SHUI G， WANG Y， et al. Remimazolam alleviates myocardial ischemia/reperfusion injury and inflammation via inhibition of the NLRP3/IL‑1β pathway in mice ［J］. Int J Mol Med， 2025， 55（4）：57.doi：10.3892/ijmm.2025.5498 . doi: 10.3892/ijmm.2025.5498
[6]	STIEGLITZ S， GOEDE V， SCHLESINGER A. Management of lung cancer in older adults ［J］. Z Gerontol Geriatr， 2025， 58（2）： 103-108.doi：10.1007/s00391-025-02412-w . doi: 10.1007/s00391-025-02412-w
[7]	CHEN L， YANG Z， CUI R， et al. Feasibility and safety of secondary video-assisted thoracoscopic surgery for ipsilateral lung cancer after prior pulmonary resection ［J］. Thorac Cancer， 2023， 14（3）： 298-303.doi：10.1111/1759-7714.14755 . doi: 10.1111/1759-7714.14755
[8]	黄文起. 老年患者手术麻醉的临床核心技术分析［J］. 中山大学学报（医学科学版）， 2019，40（4）：481-486.
[9]	KARIMI H， PATEL J， OLMOS M， et al. Spinal Anesthesia Reduces Perioperative Polypharmacy and Opioid Burden in Patients Over 65 Who Undergo Transforaminal Lumbar Interbody Fusion ［J］. World Neurosurg， 2024， 185： e758-e66.doi：10.1016/j.wneu.2024.02.127 . doi: 10.1016/j.wneu.2024.02.127
[10]	COETZEE E， ABSALOM A R. Pharmacokinetic and Pharmacodynamic Changes in the Older Adults： Impact on Anesthetics ［J］. Clin Geriatr Med， 2025， 41（1）： 19-35.doi：10.1016/j.cger.2024.03.004 . doi: 10.1016/j.cger.2024.03.004
[11]	DE WIT F， VAN VLIET A L， DE WILDE R B， et al. The effect of propofol on haemodynamics： cardiac output， venous return， mean systemic filling pressure， and vascular resistances ［J］. Br J Anaesth， 2016， 116（6）： 784-789.doi：10.1093/bja/aew126 . doi: 10.1093/bja/aew126
[12]	陈席，于贝贝，刘雨歌，等. 瑞马唑仑与丙泊酚麻醉对胸腔镜手术的老年肺癌患者术后谵妄的影响［J］. 实用医学杂志， 2025， 41（19）： 3089-3095 doi：10.3969/j.issn.1006-5725.2025.19.020 .. doi: 10.3969/j.issn.1006-5725.2025.19.020
[13]	GUPTA R， KAMAN L， DAHIYA D， et al. Effects of varying intraperitoneal pressure on liver function tests during laparoscopic cholecystectomy ［J］. J Laparoendosc Adv Surg Tech A， 2013， 23（4）： 339-342.doi：10.1089/lap.2012.0399 . doi: 10.1089/lap.2012.0399
[14]	HIRAO H， NAKAMURA K， KUPIEC-WEGLINSKI J W. Liver ischaemia-reperfusion injury： A new understanding of the role of innate immunity ［J］. Nat Rev Gastroenterol Hepatol， 2022， 19（4）： 239-256.doi：10.1038/s41575-021-00549-8 . doi: 10.1038/s41575-021-00549-8
[15]	ILIC R G. Fospropofol and remimazolam ［J］. Int Anesthesiol Clin， 2015， 53（2）： 76-90.doi：10.1097/aia.0000000000000053 . doi: 10.1097/aia.0000000000000053
[16]	旷光华，徐伟，夏瑞. 瑞马唑仑的应用现状及其研究进展［J］. 实用医学杂志， 2022， 38（13）： 1695-1700. doi：10.3969/j.issn.1006-5725.2022.13.025 . doi: 10.3969/j.issn.1006-5725.2022.13.025
[17]	FU Y， HAO K， LIN X， et al. Association between intraoperative hyperoxia and liver function in patients undergoing hepatectomy： A multicenter observational study ［J］. Langenbecks Arch Surg， 2025， 410（1）： 249.doi：10.1007/s00423-025-03832-3 . doi: 10.1007/s00423-025-03832-3
[18]	XING Q， ZHOU X， ZHOU Y， et al. Comparison of the effects of remimazolam tosylate and propofol on immune function and hemodynamics in patients undergoing laparoscopic partial hepatectomy： A randomized controlled trial ［J］. BMC Anesthesiol， 2024， 24（1）： 205.doi：10.1186/s12871-024-02589-4 . doi: 10.1186/s12871-024-02589-4
[19]	LIU X， ZHANG L， ZHAO L， et al. Comparison of the safety of remimazolam and propofol during general anesthesia in elderly patients： Systematic review and meta-analysis ［J］. Front Med （Lausanne）， 2025， 12： 1409495.doi：10.3389/fmed.2025.1409495 . doi: 10.3389/fmed.2025.1409495
[20]	STÖHR T， COLIN P J， OSSIG J， et al. Pharmacokinetic properties of remimazolam in subjects with hepatic or renal impairment ［J］. Br J Anaesth， 2021， 127（3）： 415-423.doi：10.1016/j.bja.2021.05.027 . doi: 10.1016/j.bja.2021.05.027
[21]	WANG M， ZHAO X， YIN P， et al. Profile of Remimazolam in Anesthesiology： A Narrative Review of Clinical Research Progress ［J］. Drug Des Devel Ther， 2022， 16： 3431-3444.doi：10.2147/dddt.S375957 . doi: 10.2147/dddt.S375957
[22]	LEE N， MOON K， UFFMAN J C， et al. Flumazenil Reversal of Remimazolam Sedation During Posterior Spinal Fusion in Two Adolescents ［J］. J Medi Cases， 2026， 17（1）： 32-36.doi：10.14740/jmc5221 . doi: 10.14740/jmc5221
[23]	SNEYD J R， RIGBY-JONES A E. Remimazolam for anaesthesia or sedation ［J］. Curr Opin Anaesthesiol， 2020， 33（4）： 506-511.doi：10.1097/aco.0000000000000877 . doi: 10.1097/aco.0000000000000877
[24]	RAMIREZ K， NIRAULA A， SHERIDAN J F. GABAergic modulation with classical benzodiazepines prevent stress-induced neuro-immune dysregulation and behavioral alterations ［J］. Brain Behav Immun， 2016， 51： 154-168.doi：10.1016/j.bbi.2015.08.011 . doi: 10.1016/j.bbi.2015.08.011
[25]	刘国英，吴滨，逯素芬，等. 瑞马唑仑对颅脑介入手术患者血流动力学及术后康复影响［J］. 临床军医杂志， 2023， 51（1）： 60-62.doi：10.16680/j.1671-3826.2023.01.16 . doi: 10.16680/j.1671-3826.2023.01.16
[26]	ELGEBALY A S， FATHY S M， SALLAM A A， et al. Cardioprotective effects of propofol-dexmedetomidine in open-heart surgery： A prospective double-blind study ［J］. Ann Card Anaesth， 2020， 23（2）： 134-141.doi：10.4103/aca.ACA_168_18 . doi: 10.4103/aca.ACA_168_18
[27]	阿尔达克·夏买提，魏靖茹，陆天佑等.胸腹按压对无痛胃镜患者丙泊酚镇静引起呼吸抑制的预防［J］.中山大学学报（医学科学版），2022，43（4）：631-638.doi： 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20220509.002 . doi: 10.13471/j.cnki.j.sun.yat-sen.univ（med.sci）.20220509.002
[28]	TAKAKI R， YOKOSE M， MIHARA T， et al. Hypotension after general anaesthesia induction using remimazolam or propofol in geriatric patients undergoing sevoflurane anaesthesia with remifentanil： A single-centre， double-blind， randomised controlled trial ［J］. Br J Anaesth， 2024， 133（1）： 24-32.doi：10.1016/j.bja.2024.04.013 . doi: 10.1016/j.bja.2024.04.013
[29]	YOKOSE M， TAKAKI R， MIHARA T， et al. Hypotension after general anesthesia induction using remimazolam in geriatric patients： Protocol for a double-blind randomized controlled trial ［J］. PLoS One， 2022， 17（9）： e0275451.doi：10.1371/journal.pone.0275451 . doi: 10.1371/journal.pone.0275451
[30]	SNEYD J R， GAMBUS P L， RIGBY-JONES A E. Current status of perioperative hypnotics， role of benzodiazepines， and the case for remimazolam： A narrative review ［J］. Br J Anaesth， 2021， 127（1）： 41-55.doi：10.1016/j.bja.2021.03.028 . doi: 10.1016/j.bja.2021.03.028
[31]	DONG S A， GUO Y， LIU S S， et al. A randomized， controlled clinical trial comparing remimazolam to propofol when combined with alfentanil for sedation during ERCP procedures ［J］. J Clin Anesth， 2023， 86： 111077.doi：10.1016/j.jclinane.2023.111077 . doi: 10.1016/j.jclinane.2023.111077
[32]	THANDRA K C， BARSOUK A， SAGINALA K， et al. Epidemiology of lung cancer ［J］. Contemp Oncol （Pozn）， 2021， 25（1）： 45-52.doi：10.5114/wo.2021.103829 . doi: 10.5114/wo.2021.103829
[33]	REX D K， BHANDARI R， DESTA T， et al. A phase III study evaluating the efficacy and safety of remimazolam （CNS 7056） compared with placebo and midazolam in patients undergoing colonoscopy ［J］. Gastrointest Endosc， 2018， 88（3）： 427-437.e6.doi：10.1016/j.gie.2018.04.2351 . doi: 10.1016/j.gie.2018.04.2351

项目	P组（n = 59）	R组（n = 58）	t/χ² 值	P值
性别/例			0.152	0.689
男	36	33
女	23	25
年龄/岁	69.81 ± 3.08	69.74 ± 3.11	0.143	0.887
BMI/（kg/m²）	22.7 ± 1.0	22.8 ± 0.9	0.505	0.612
ASA/例			0.002	0.973
Ⅱ级	43	42
Ⅲ级	16	16

项目	P组（n = 59）	R组（n = 58）	t/Z值	P值
手术时间/min	165.3 ± 9.7	167.8 ± 10.2	-1.468	0.145
麻醉时间/min	180.5 ± 11.3	183.2 ± 11.8	-1.375	0.172
瑞芬太尼用量/mg	1.8±0.3	1.7 ± 0.2	1.989	0.053
尿量M（IQR）/mL	500（400，500）	500（400，500）	0.135	0.891
出血量M（IQR）/mL	50（40，60）	50（50，50）	0.301	0.764
补液量M（IQR）/mL	1 500（1 400，1 600）	1 500（1 350，1 650）	0.265	0.789

时间点	P组（n = 59）	R组（n = 58）	t值	P值
T₁	95.7 ± 1.6	95.4 ± 1.2	0.984	0.327
T₂	48.3 ± 2.6	48.3 ± 2.2	-0.090	0.928
T₃	42.2 ± 2.9	42.5 ± 2.4	-0.430	0.668
T₄	38.3 ± 3.0	38.5 ± 2.3	-0.397	0.692
T₅	35.3 ± 3.0	35.0 ± 2.8	0.630	0.503
T₆	37.1 ± 2.7	37.3 ± 2.0	-0.597	0.552
T₇	93.4 ± 2.4	93.0 ± 1.2	1.321	0.188

项目	时间	P组	R组	t值	P值
ALT/（U/L）	术前	23.5 ± 3.0	22.5 ± 3.1	1.799	0.075
	术后第1天	35.5 ± 1.8*	34.7 ± 2.9*	1.651	0.102
	术后第3天	28.2 ± 3.0	27.5 ± 2.8	1.446	0.151
AST/（U/L）	术前	21.8 ± 3.0	21.2 ± 2.7	1.068	0.288
	术后第1天	31.1 ± 2.3*	30.2 ± 2.8*	1.692	0.093
	术后第3天	25.6 ± 2.5	25.1 ± 2.4	0.886	0.377
TBIL/（μmol/L）	术前	12.6 ± 1.8	12.3 ± 1.6	1.151	0.252
	术后第1天	20.4 ± 2.2*	20.2 ± 1.8*	0.588	0.558
	术后第3天	15.3 ± 1.8	14.8 ± 1.3	1.819	0.071

项目	P组（n = 59）	R组（n = 58）	t值	P值
术前	135.5 ± 4.3	136.4 ± 4.1	-1.140	0.257
术后第1天	107.1 ± 6.7 ^*	117.2 ± 5.6^*	-8.862	< 0.001
术后第3天	125.3 ± 5.1^*	132.5 ± 4.3^*	-8.837	< 0.001

Comparison of the effects of remimazolam versus propofol for general anesthesia maintenance on postoperative liver function， quality of recovery， and perioperative safety in elderly patients undergoing video-assisted thoracoscopic lobectomy for lung cancer

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项目	时间	P组（n = 59）	R组（n = 58）	t值	P值
MAP/mmHg	T₁	87.4 ± 3.2	86.5 ± 3.1	1.588	0.122
	T₂	68.0 ± 2.9	79.7 ± 3.0	-21.948	< 0.001
	T₃	71.0 ± 3.1	82.9 ± 3.1	-20.772	< 0.001
	T₄	82.6 ± 3.1	83.6 ± 2.8	-1.644	0.103
	T₅	85.1 ± 3.4	86.1 ± 3.5	-1.564	0.120
	T₆	84.5 ± 2.6	85.0 ± 2.8	-0.949	0.344
	T₇	86.4 ± 3.7	86.8 ± 3.4	-0.509	0.556
HR/（次/min）	T₁	76.7 ± 4.4	76.0 ± 4.3	0.882	0.380
	T₂	68.7 ± 5.1	69.8 ± 3.7	-1.244	0.216
	T₃	66.7 ± 5.3	71.2 ± 4.4	-4.733	< 0.001
	T₄	71.3 ± 3.4	70.8 ± 4.4	0.607	0.545
	T₅	82.9 ± 3.1	83.7 ± 3.2	-1.302	0.195
	T₆	81.4 ± 3.2	82.3 ± 3.6	-1.451	0.150
	T₇	77.1 ± 3.8	78.4 ± 3.7	-1.757	0.082

项目	P组(n = 59)	R组(n = 58)	t值	P值
拔管时间	30.5 ± 2.1	25.2 ± 1.6	15.038	< 0.001
PACU停留时间	65.2 ± 4.3	59.8 ± 4.0	5.789	< 0.001

项目	P组（n = 59）	R组（n = 58）	χ² 值	P值
恶心呕吐	15（25.4）	12（20.7）	0.438	0.514
低氧血症	7（11.9）	3（5.2）	2.079	0.168
低血压	3（5.1）	1（1.7）	1.015	0.365

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