Effects of General Anesthesia Induced by Remimazolam and Propofol on Adverse and Inflammatory Reactions in Patients After Colorectal Cancer Surgery: A Retrospective Study.

Abstract

Aims/Background Globally, colorectal cancer ranks as the third most common malignant tumor. This study aims to evaluate and compare the effects of remimazolam versus propofol in patients undergoing surgical treatment for colorectal cancer. Methods This study retrospectively analyzed 160 patients who underwent colorectal cancer surgery from January 2023 to December 2024 at the First People's Hospital of Xiaoshan District. Seventy-five patients receiving propofol anesthesia were classified in the control group, whereas 85 patients anesthesized with remimazolam were categorized in the study group. Anesthesia index levels, recovery quality (Riker sedation-agitation scale [SAS] and confusion assessment method-Chinese revision [CAM-CR]), mean arterial pressure (MAP), heart rate (HR), adverse effects and levels of inflammatory factors, such as interleukin (IL)-6, IL-8, tumor necrosis factor alpha (TNF-α), were analyzed using chi-squared test and t-tests. Results In the study group, the time to anesthesia onset, recovery duration, length of stay in the post-anesthesia care unit (PACU), as well as the SAS and CAM-CR scores, were significantly shorter compared to those in the control group (p < 0.05). At 3 min before anesthesia (T1), there were no differences in MAP and heart rate levels between the two groups (p > 0.05). At 30 min after anesthesia (T2), immediately after surgery (T3), and 5 min after surgery (T4), the MAP of the study group exceeded those observed in the control group (p < 0.05). The incidence of adverse reactions in the study group was 10.59% (9/85), which was significantly lower than that in the control group (37.33% (28/75)) (p < 0.05). Furthermore, during the same postoperative period, levels of IL-6, IL-8, and TNF-α were found to be reduced in the study group compared to the control group (p < 0.05). Conclusion Remimazolam outperforms propofol in inducing general anesthesia for patients undergoing colorectal cancer surgery, evidenced by improvement in recovery quality and hemodynamic level, as well as reduction in the incidence of adverse effects and inflammatory level.