Abstract
BACKGROUND: Ureteral stone lithotripsy may cause a strong inflammatory response and may be associated with patient outcomes. In clinical practice, remimazolam has been widely used for induction and maintenance of general anesthesia. The purpose of this study is to investigate the effect of remimazolam on the postoperative inflammatory response in patients undergoing ureteral lithotripsy. METHOD: The trial was registered at the China Clinical Trial Registration Center (ChiCTR2300070006) on March 31, 2023. The study included 80 patients who underwent lithotripsy for ureteral stones, and they were divided into two groups. Patients in the remimazolam group (n = 40) or propofol group (n = 40) received sufentanil and cisatracurium in combination for induction and maintenance of anesthesia. The levels of interleukin-6 (IL-6), Tumor necrosis factor (TNF)-α, C-reactive protein (CRP) and procalcitonin (PCT) were measured before and 24 h after operation. The recovery time, recovery quality score and postoperative complications were recorded. RESULT: Compared with the propofol group, the changes of IL-6, TNF-α and CRP in the remimazolam group were significantly decreased before and after operation (p < 0.05), but the changes of PCT before and after operation were not significantly different (P > 0.05). The time of extubation was shorter in the remimazolam group than that in the propofol group (p < 0.05), but the scores of MOAA/s and Rass in the remimazolam group were lower than that in the propofol group within 20 min after operation (p < 0.05), there was no significant difference in the incidence of complications between the two groups. CONCLUSION: Remimazolam is effective in reducing the 24-hour inflammatory response after ureteral stone lithotripsy and is safe and effective for use in this procedure.