Abstract
BACKGROUND: Hysteroscopy, a minimally invasive gynecological procedure, requires effective sedation for patient comfort and surgical success. Remimazolam Besylate, a new ultra-short-acting benzodiazepine, offers potential for safe sedation, but the optimal dose for postoperative outcomes is unclear. This study evaluated the effects of different doses of Remimazolam Besylate on postoperative sedation, pain, and adverse reactions in hysteroscopic surgery patients. METHODS: From June 2020 to June 2022, 90 patients undergoing hysteroscopic surgery under general anesthesia were randomly divided into three subgroups (A, B, C; n = 30 each). Subgroup A received 0.2 mg/kg, Subgroup B received 0.3 mg/kg, and Subgroup C received 0.4 mg/kg of Remimazolam Besylate intravenously during anesthesia induction. Postoperative outcomes, including pain stress mediators (PGE2 and 5-HT), Pain Visual Analogue Scale (VAS) scores, Ramsay Sedation scores, and adverse events, were compared among the subgroups. RESULTS: Subgroup A (0.2 mg/kg) showed significantly higher levels of PGE2 and 5-HT at 2, 12, and 24 h postoperatively compared to Subgroups B (0.3 mg/kg) and C (0.4 mg/kg). VAS scores at 2 and 12 h were higher in Subgroup A, while Ramsay Sedation scores were lower. Subgroup C had a significantly higher incidence of adverse reactions compared to Subgroups A and B. CONCLUSION: Remimazolam Besylate at a dose of 0.3 mg/kg is optimal for anesthesia induction in hysteroscopic surgery, providing effective sedation, reduced postoperative pain, and a lower incidence of adverse reactions compared to higher doses. This dose is recommended for achieving balanced sedation and safety outcomes.