Effect of propofol and remimazolam on post-induction hypotension in hypertensive patients undergoing laparoscopic cholecystectomy

Table 1 Comparison of general data between the two groups of patients, n (%)/mean ± SD

Variable	Remimazolam group (n = 88)	Propofol group (n = 89)	t/χ2 value	P value
Male	46 (52.27)	45 (50.56)	0.051	0.882
Age (year)	65.92 ± 8.15	66.45 ± 7.89	0.418	0.677
BMI (kg/m2)	24.58 ± 3.02	24.92 ± 2.95	0.736	0.462
ASA classification (II/III)	64/24	66/23	0.156	0.925
Diabetes	22(25.00)	25(28.09)	0.321	0.572
Type of antihypertensive drugs
ACEI/ARB	65 (73.86)	74 (83.15)	0.233	0.233
CCB	32 (36.36)	42 (47.19)	0.173	0.173
Diuretic	20 (22.73)	18 (20.22)	0.666	0.666
Others	2 (2.27)	3 (3.37)	0.667	0.667
Duration of hypertension (year)	8.65 ± 3.22	8.98 ± 3.45	0.762	0.447
Preoperative systolic pressure (mmHg)	139.65 ± 10.32	139.91 ± 9.87	0.385	0.700
Preoperative diastolic pressure (mmHg)	88.36 ± 6.21	87.92 ± 5.98	0.452	0.652
Surgical duration (minute)	58.12 ± 11.65	58.89 ± 12.03	0.436	0.663
Intraoperative blood loss (mL)	14.89 ± 8.35	15.76 ± 8.12	0.568	0.570

BMI: Body mass index; ASA: American Society of Anesthesiologists; ACEI: Angiotensin-converting enzyme inhibitor; ARB: Angiotensin receptor blocker; CCB: Calcium channel blocker.

Table 2 Comparison of postoperative anesthesia and recovery between the two groups, n (%)/mean ± SD/median (interquartile range)

Variable	Remimazolam group (n = 88)	Propofol group (n = 89)	Statistic	P value
Post-induction hypotension incidence	36 (40.91)	69 (77.53)	15.286	< 0.001
Time to reach BIS 60 (second)	77.65 ± 8.02	59.89 ± 6.15	14.892	< 0.001
Time to loss of eyelash reflex (second)	51.36 ± 8.89	34.65 ± 7.58	13.258	< 0.001
Recovery time (second)	508.45 ± 52.23	517.92 ± 58.11	1.786	0.076
Extubation time (second)	541.12 ± 52.75	564.68 ± 62.59	1.352	0.178
Time-weighted average of hypotension (mmHg)	0.00 (0.00, 0.71)	0.55 (0.00, 4.68)	-5.123	< 0.001
Total duration of hypotension (minute)	0.00 (0.00, 5.00)	3.00 (0.00, 8.00)	-5.234	< 0.001
Total norepinephrine use after induction (μg)	0.00 (0.00, 16.00)	14.00 (0.00, 28.00)	-5.567	< 0.001

BIS: Bispectral Index.

Table 3 Comparison of the incidence of adverse reactions between the two groups, n (%)

Adverse event	Remimazolam group (n = 88)	Propofol group (n = 89)	χ2 value	P value
Injection pain during induction	2 (2.27)	19 (21.35)	15.398	< 0.001
Bradycardia (HR < 50 beats/minute)	3 (3.41)	5 (5.62)	0.500	0.479
Nausea and vomiting	2 (2.27)	4 (4.49)	0.667	0.414
Hypoxemia (SpO2 < 95%)	2 (2.27)	3 (3.37)	0.194	0.659

HR: Heart rate; SpO₂: Oxygen saturation.

Table 4 Comparison of Quality of Recovery Score and Riker Sedation-Agitation Scale scores at different time points after surgery in the two groups of patients, mean ± SD

Time point	Remimazolam group (n = 88)	Propofol group (n = 89)	Statistic	P value
RSAS score
1 minute after extubation	4.12 ± 0.43	4.88 ± 0.91	-7.121	< 0.001
15 minutes after extubation	4.04 ± 0.32	4.92 ± 0.58	-12.525	< 0.001
30 minutes after extubation	4.06 ± 0.24	4.98 ± 0.47	-14.174	< 0.001
QoR-15 score
6 hours after surgery	104.62 ± 8.37	102.74 ± 10.16	1.751	0.152
12 hours after surgery	114.34 ± 8.94	112.47 ± 9.68	1.421	0.163
24 hours after surgery	118.53 ± 7.58	116.84 ± 8.26	1.377	0.172

RSAS: Riker Sedation-Agitation Scale; QoR-15: Quality of Recovery Score.