Effect of Remimazolam on Cellular Immune Response and Postoperative Recovery in Patients Undergoing Laparoscopic Colorectal Cancer Surgery

Jianyan Wu; Huijie Ma; Boya Zhang; Ying Wang; Yingui Sun

doi:10.18502/ijaai.v24i1.18019

Jianyan Wu School of Anesthesiology, Shandong Second Medical University, Weifang, China
Huijie Ma School of Anesthesiology, Shandong Second Medical University, Weifang, China
Boya Zhang School of Anesthesiology, Shandong Second Medical University, Weifang, China
Ying Wang School of Anesthesiology, Shandong Second Medical University, Weifang, China
Yingui Sun School of Anesthesiology, Shandong Second Medical University, Weifang, China

DOI: https://doi.org/10.18502/ijaai.v24i1.18019

Keywords: Cellular immune function; Colorectal cancer surgery; General anesthesia; Natural killer cells; Postoperative recovery; Remimazolam

Abstract

We aimed to evaluate the effect of remimazolam-based general anesthesia on cellular immune function and postoperative recovery quality in patients undergoing laparoscopic radical colorectal cancer surgery.

A total of 90 patients scheduled for elective laparoscopic colorectal cancer radical surgery were randomly divided into 2 groups: the remimazolam group (Group R) and the propofol group (Group P), with 45 patients in each group. Anesthesia induction in Group R involved intravenous remimazolam, and in Group P, intravenous propofol until the loss of consciousness (modified observer’s assessment of alertness/sedation [MOAA/S] score 1–2). Both groups then received intravenous sufentanil and cisatracurium for intubation. Cellular immune function markers (CD3⁺, CD4⁺, CD8⁺ T and natural killer [NK] cells) were recorded at different time points. Quality of Recovery [QoR]-15 scale scores, hemodynamic parameters, sedation scores (Riker and Ramsay scales), recovery times and adverse events were also recorded.

Compared to Group P, Group R had significantly higher NK, CD3⁺, and CD4⁺ cell levels immediately after surgery and at 24 hours postoperatively. Group R showed a significantly lower incidence of intraoperative hypotension, bradycardia, and vasopressor use. Additionally, QoR-15 scores at 24 and 72 hours were higher in Group R. There were no significant differences in Riker or Ramsay scores, extubation time, post-anesthesia care unit stay, or the incidence of postoperative nausea, vomiting, and drowsiness between the 2 groups.

Compared with propofol, remimazolam anesthesia results in better perioperative immune function preservation, reduced intraoperative hypotension and bradycardia, and improved postoperative recovery quality in patients undergoing laparoscopic radical colorectal cancer
surgery.