Abstract
INTRODUCTION: Remimazolam is a new sedative-hypnotic drug, which has been demonstrated to be safe and effective for the induction and maintenance of anesthesia, but its effects on the postoperative sleep quality of patients remain unknown. METHODS: Patients enrolled in this study were randomly received remimazolam (Group R) or propofol (Group P) for induction and maintenance of anesthesia. The primary outcome was the Athens insomnia scale (AIS) score. The secondary outcomes included smart wristband data on the first night after surgery, the Ramsay sedation scale score at 1 h postoperatively, time from drug withdrawal to laryngeal mask removal, postanesthesia care unit (PACU) discharge time, postoperative nausea and vomiting, intraoperative awareness and reported adverse reactions. RESULTS: The AIS score on postoperative day 1 was higher in group R compared with group P, but no significant difference was found between the two groups in 8 items of the AIS on postoperative day 1. Additionally, there was no significant difference in the proportion of patients with suspected insomnia and insomnia between the two groups at POD 1. The monitoring data of smart wristband found that compared with group P, the total sleep duration of the first night after surgery of group R was decreased, and the proportion of deep sleep was reduced. Moreover, the time from drug withdrawal to laryngeal mask removal and PACU discharge time was longer in group R than group P. The Ramsay sedation scale score at 1 h postoperatively was higher in group R than group P. There were no statistically significant differences between groups for postoperative nausea and vomiting. Furthermore, neither group experienced any intraoperative awareness or serious adverse events. CONCLUSIONS: Total intravenous anesthesia using remimazolam decreased postoperative sleep quality in patients undergoing laparoscopic hysterectomy compared to propofol. The effect of remimazolam on postoperative sleep quality may primarily manifest in the severity rather than the incidence of insomnia. Patients needed a more extended recovery period afterward and had higher sedation scores following recovery.