Effect of remazolam combined with hydromorphone postoperative analgesia on cognitive function in elderly patients...

To investigate the effect of remazolam combined with hydromorphone on postoperative cognitive function in elderly patients undergoing hip replacement.

184 elderly patients who underwent hip replacement in Sir Run Run Shaw hospital from January 2023 to January 2025 were retrospectively analyzed. According to the intraoperative anesthesia scheme, they were divided into an observation group (remazolam combined with postoperative hydromorphone analgesia) and a control group (propofol combined with postoperative hydromorphone analgesia). The intraoperative hemodynamics, anesthesia recovery, incidence of cognitive dysfunction (POD) within 7 days after operation, scores of mini-mental state examination (MMSE) and Montreal cognitive assessment (MoCA), visual analogue scale (VAS) score within 48 hours after operation, hydromorphone dosage, joint function score, adverse reactions, and analgesia satisfaction were compared between the two groups.

There was no significant difference in intraoperative hemodynamic indexes or post-anesthesia monitoring treatment room stay time between the two groups (P > 0.05), but the eye opening time and extubation time in the observation group were shorter (P < 0.05) and the incidence of POD in the observation group were lower than in the control group within 7 days after operation. The scores of MoCA and MMSE in the observation group were higher than those in the control group on the 1st and 3rd day after operation (P < 0.05), but there was no difference between the two groups on the 7th day after operation. There was no significant difference in VAS scores between the two groups at each time point after operation, but the cumulative dosage of hydromorphone in the observation group was higher at 6 hours and 24 hours after operation (P < 0.05), and there was no difference between the two groups at 48 hours. The analgesic satisfaction of the observation group was higher (P < 0.05). There was no significant difference in the incidence of adverse reactions or joint function scores between the two groups.

Remazolam combined with hydromorphone for postoperative analgesia in elderly patients undergoing hip replacement can help reduce the incidence of early POD, promote anesthesia recovery, improve analgesia satisfaction, and does not increase adverse reactions.