Observational study on the application of remazolam toluenesulfonate and propofol in abortion

Background: Anesthetic effects of remazolam and propofol have never been compared in induced abortion. This study aimed to compare their safety and efficacy. Methods: Sixty-two patients who underwent painless abortion in our hospital were randomly divided into two equal groups: remazolam tosylate(0.26 mg/kg; 1.3 ED50) + fentanyl ( 1 μg/kg) (RF group) or intravenous propofol(2 mg/kg) + fentanyl ( 1 μg/kg) (PF group). Additional rescue sedation with propofol ( 1 mg/kg) was administered based on body movement and operation duration. The heart rate (HR), mean arterial pressure (MAP), oxygen saturation, Narcotrend Index, Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score, awakening time, remedial sedation, and adverse reactions were compared between groups at eight time points:upon operating room entry (T0), 1 min post-fentanyl and post-remifentanil/propofol administration (T1,T2), upon initiation of the operation (T3), 3 and 5 min post-operation (T4,T5), at the end of operation (T6), and upon awakening (T7). Results: Large circulatory fluctuations were observed in the PF group; the MAP decreased significantly, as did the HR at T0 compared with T4 (P<0.05). Based on the Narcotrend Index values assessed over time, both groups reached clinical sedation, with significantly lower values at T2, T3, and T4 than at T0 (P<0.05). The Narcotrend Index in the PF group was significantly lower than that in the RF group at T2, T3, and T4 (P<0.05). Within each group, the MOAA/S scores were significantly lower at T2 and T3 (P<0.05). Conclusion: Remazolam tosylate is more efficacious and induces fewer adverse reactions than propofol in painless abortion.