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Cancer research

Remimazolam Shows Promise in Reducing Perioperative Neurocognitive Dysfunction in Elderly Patients

Strategic Insights

— 2 min read

Recent research published in Drug Design, Development and Therapy has investigated the effects of remimazolam on elderly patients undergoing laparoscopic colorectal surgery. The study, conducted by Zhenqi Liu and colleagues at the Department of Anesthesiology, found that medium and high doses of remimazolam can significantly reduce the incidence of perioperative neurocognitive dysfunction compared to propofol. However, high-dose remimazolam anesthesia maintenance may lead to prolonged extubation time, increased postoperative shivering, and potential re-sedation after awakening.

Key Takeaways:

  • 120 elderly patients were randomly assigned to four groups: three experimental groups (R1-R3) receiving different remimazolam maintenance doses and one control group (P) receiving propofol.
  • The study found that medium and high doses of remimazolam (1.0 mg/kg/h and 1.5 mg/kg/h, respectively) significantly improved postoperative cognitive function scores compared to low-dose remimazolam (0.5 mg/kg/h) and propofol.
  • High-dose remimazolam was associated with prolonged extubation time, increased postoperative shivering, and potential re-sedation after awakening.
  • Medium-dose remimazolam (1.0 mg/kg/h) showed a more favorable safety profile and is recommended for intraoperative anesthesia maintenance in elderly patients.
  • The study included 117 patients, with 3 excluded due to intraoperative conversion to open surgery.
  • The research utilized the MMSE and MoCA assessments to evaluate perioperative cognitive function.

Statistics:

  • 120 patients were enrolled in the study, with 117 ultimately included in the analysis.
  • 30 patients were assigned to each of the control group (P) and the R1 group (0.5 mg/kg/h remimazolam).
  • 28 patients were assigned to the R2 group (1.0 mg/kg/h remimazolam), 30 to the R3 group (1.5 mg/kg/h remimazolam).
  • The study found significant improvements in postoperative cognitive function scores for the R2 and R3 groups compared to the R1 and P groups.
  • The R2 and R3 groups showed similar postoperative cognitive function scores.
  • High-dose remimazolam was associated with a prolonged extubation time (mean 20.5 ± 5.1 minutes vs. 12.9 ± 3.2 minutes in the R2 group).

Sources:

  • Liu, Z., et al. (2025). Dose-Dependent Effects of Remimazolam on Early Perioperative Neurocognitive Disorders in Elderly Colorectal Cancer Patients Undergoing Laparoscopic Surgery. Drug Design, Development and Therapy, 19(1), 5507-5516. (Drug Design, Development and Therapy - http://www.dovepress.com/drug-design-development-and-therapy-journal)
  • NewsRx. Studies from Department of Anesthesiology Reveal New Findings on Colon Cancer (Dose-Dependent Effects of Remimazolam on Early Perioperative Neurocognitive Disorders in Elderly Colorectal Cancer Patients Undergoing Laparoscopic Surgery). Cancer Weekly. July 15, 2025; p 923.

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