Effects of remimazolam combined with mivacurium on recovery quality of patients after vocal cord polypectomy

Abstract

Objective To evaluate the effects of remimazolam versus propofol on the quality of postoperative recovery in patients undergoing vocal cord polypectomy with supportive laryngoscopy by the 15-item quality of recovery scale (QoR-15). Methods A total of 90 patients who underwent vocal cord polypectomy with supported laryngoscopy from the Fourth Clinical College of Xinxiang Medical University from December 2022 to October 2023 were divided into remimazolam combined with mivacurium group (group R) and propofol combined with mivacurium group (group P) by random block design method, with 45 cases in each group. By intravenous administration, patients in group R and group P were given remiazolam 0.2 to 0.3 mg/kg and propofol 1.5 to 2.0 mg/kg, respectively. After the disappearance of eyelash reflex, sufentanil 0.3 g/kg and mivacurium 0.25 mg/kg were given to all patients. The quality of postoperative recovery was evaluated by the QoR-15 scale 1 day before, 1 day and 2 days after surgery. Mean arterial pressure, heart rate, pulse oxygen saturation, and Modified Observers Assessment of Alertness/Sedation Scale (MOAA/S) scores of the two groups were recorded at different time points. The time required including surgery, recovery of spontaneous breathing, endotracheal tube removal, and post anesthesia care unit (PACU) stay after surgery,and the occurrence of intra- and post-operative adverse reactions were recorded. Results The QoR-15 scale score of group R was lower than that of group P (P＜0.05) on the first day after surgery, but it was not clinically significant because the minimum clinically significant change value of QoR-15 scale score was 6 points. The recovery time of spontaneous breathing and extubation time in group R were longer than those in group P (P＜0.05), but there was no significant difference in PACU stay time between the two groups (P＞0.05). The incidences of hypotension and injection site pain in group R were lower than those in group P (24.4% vs 64.4%, χ2=14.580, P＜0.01; 6.7% vs 84.4%, χ2=54.878, P＜0.01), and no significant difference was found in the incidence of other adverse reactions (P＞0.05). ConclusionIn the anesthesia of vocal cord polypectomy under supported laryngoscopy, the quality of patients recovery using remimazolam is comparable to that of propofol. While meeting perioperative needs, it can maintain more stable hemodynamics, without significant injection site pain, and can improve perioperative patients comfort."

Keywords

• vocal cord polypectomy，postoperative recovery quality， remimazolam， mivacurium，propofol， the 15-item quality of recovery scale