Objective  To investigate the effect of remimazolam on entropy index and sedation score in elderly patients after hip replacement.

Methods  The clinical data of patients who underwent hip replacement in Hangzhou Fuyang Hospital of Orthopedics of Traditional Chinese Medicine from June 2021 to June 2024 were retrospectively analyzed and divided into the low-dose group and the high-dose group according to the different doses of remimazolam used during the operation. The response entropy (RE), state entropy (SE) and bispectral index (BIS) of brain function entropy index at each time point, Ramsay sedation score, cognitive function (MoCA and MMSE) score at each time point, perioperative anesthesia-related indicators and postoperative adverse reactions were compared between the two groups.

Results  A total of 100 patients were included, with 52 in the high-dose group and 48 in the low-dose group. The RE, SE and BIS values of the two groups at each time point during the operation were decreased compared with those before the operation (P<0.05), and the Ramsay scores were higher than those before the operation (P<0.05), but there was no statistically significant difference between the two groups (P>0.05). Compared with the high-dose group, the intraoperative MAP and HR fluctuations in the low-dose group were smaller, the MoCA and MMSE scores in the low-dose group were higher after surgery (P<0.05), the recovery room stay and awakening time in the low-dose group were shorter (P<0.05), and the total incidence of adverse reactions in the low-dose group was lower (P<0.05).

Conclusion  Low-dose remimazolam can provide good sedation effect for elderly patients undergoing hip replacement, maintain hemodynamic stability, reduce the occurrence of postoperative cognitive dysfunction, shorten recovery time, and has better safety.

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