Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgery

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...

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Main Authors: Linjiang Yang, Liang Zhong, Xu Deng, Hao Fang, Siqin Li, Yi Li
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Surgery
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Online Access:https://doi.org/10.1186/s12893-025-03017-1
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author Linjiang Yang
Liang Zhong
Xu Deng
Hao Fang
Siqin Li
Yi Li
author_facet Linjiang Yang
Liang Zhong
Xu Deng
Hao Fang
Siqin Li
Yi Li
author_sort Linjiang Yang
collection DOAJ
description 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.
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spelling doaj-art-d120f99f7f7c437490aa6e16c3edf22e2025-08-20T03:45:24ZengBMCBMC Surgery1471-24822025-07-0125111010.1186/s12893-025-03017-1Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgeryLinjiang Yang0Liang Zhong1Xu Deng2Hao Fang3Siqin Li4Yi Li5Department of anesthesiology, Tongji Medical College, Wuhan Children’s hospital Wuhan Meternal and Child Healthcare Hospital, Huazhong University of Science & TechnologyDepartment of anesthesiology, Tongji Medical College, Wuhan Children’s hospital Wuhan Meternal and Child Healthcare Hospital, Huazhong University of Science & TechnologyDepartment of anesthesiology, Tongji Medical College, Wuhan Children’s hospital Wuhan Meternal and Child Healthcare Hospital, Huazhong University of Science & TechnologyDepartment of anesthesiology, Tongji Medical College, Wuhan Children’s hospital Wuhan Meternal and Child Healthcare Hospital, Huazhong University of Science & TechnologyDepartment of anesthesiology, Tongji Medical College, Wuhan Children’s hospital Wuhan Meternal and Child Healthcare Hospital, Huazhong University of Science & TechnologyDepartment of anesthesiology, Tongji Medical College, Wuhan Children’s hospital Wuhan Meternal and Child Healthcare Hospital, Huazhong University of Science & TechnologyAbstract 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.https://doi.org/10.1186/s12893-025-03017-1Remimazolam besylateHysteroscopic surgeryPostoperative sedationPain stress mediatorsAdverse reactions
spellingShingle Linjiang Yang
Liang Zhong
Xu Deng
Hao Fang
Siqin Li
Yi Li
Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgery
BMC Surgery
Remimazolam besylate
Hysteroscopic surgery
Postoperative sedation
Pain stress mediators
Adverse reactions
title Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgery
title_full Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgery
title_fullStr Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgery
title_full_unstemmed Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgery
title_short Effects of different doses of remimazolam besylate on postoperative sedation, pain, and adverse reactions in patients undergoing hysteroscopic surgery
title_sort effects of different doses of remimazolam besylate on postoperative sedation pain and adverse reactions in patients undergoing hysteroscopic surgery
topic Remimazolam besylate
Hysteroscopic surgery
Postoperative sedation
Pain stress mediators
Adverse reactions
url https://doi.org/10.1186/s12893-025-03017-1
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