Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial

Hao Wu,1,* Shunping Tian,1,* Hongxia Ma,2,* Wei Zhou,1 Shantian Feng,1 Lijun Meng,3 Jinlei Ou,3 Fei Xu,1 Zhuan Zhang1 1Department of Anesthesiology, The Affiliated Hospital of Yangzhou University, Yangzhou, 225012, People’s Republic of China; 2Department of Anesthesiology, Th...

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Main Authors: Wu H, Tian S, Ma H, Zhou W, Feng S, Meng L, Ou J, Xu F, Zhang Z
Format: Article
Language:English
Published: Dove Medical Press 2024-12-01
Series:Clinical Interventions in Aging
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Online Access:https://www.dovepress.com/effects-of-remimazolam-on-intraoperative-frontal-alpha-band-power-spec-peer-reviewed-fulltext-article-CIA
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author Wu H
Tian S
Ma H
Zhou W
Feng S
Meng L
Ou J
Xu F
Zhang Z
author_facet Wu H
Tian S
Ma H
Zhou W
Feng S
Meng L
Ou J
Xu F
Zhang Z
author_sort Wu H
collection DOAJ
description Hao Wu,1,&ast; Shunping Tian,1,&ast; Hongxia Ma,2,&ast; Wei Zhou,1 Shantian Feng,1 Lijun Meng,3 Jinlei Ou,3 Fei Xu,1 Zhuan Zhang1 1Department of Anesthesiology, The Affiliated Hospital of Yangzhou University, Yangzhou, 225012, People’s Republic of China; 2Department of Anesthesiology, The Second People’s Hospital of Lianyungang, Lianyungang, 222023, People’s Republic of China; 3Intensive Care Unit, The Affiliated Hospital of Yangzhou University, Yangzhou, 225012, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhuan Zhang, Department of Anesthesiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, 225012, People’s Republic of China, Tel +86 15062791355, Email zhangzhuancg@163.comPurpose: Low density of electroencephalogram alpha band power was reported to be associated with perioperative cognitive dysfunction. Few studies have conducted to explore the effects of remimazolam on intraoperative frontal alpha band power spectrum density in older adults. Here, we aimed to explore the impact of remimazolam on intraoperative frontal brain wave alpha band activity and postoperative cognitive function in older adults undergoing lower extremity fractures surgeries.Methods: Patients undergoing elective general anesthesia for lower extremity fracture surgery were randomly allocated to remimazolam group (Group R) and midazolam group (Group M). Group R was induced with remimazolam bolus 0.1 mg/kg followed by a maintenance dose of 0.1 mg·kg− 1·h− 1 for general anesthesia. Group M was induced with midazolam 0.05 mg/kg followed by normal saline maintenance of 0.1 mL·kg− 1·h− 1. The rest anesthesia protocol was the same for both groups. Electroencephalogram data was recorded before anesthesia induction till the end of surgery. Cognitive function was assessed preoperatively, and at the first, third, fifth, and seventh day postoperatively.Results: Compared with Group M, Group R had significantly higher intraoperative power spectral density of the frontal alpha band (P < 0.001), and significantly lower incidence of postoperative cognitive dysfunction at T8 and T9 (P = 0.031 and P = 0.017, respectively).Conclusion: Remimazolam can increase frontal brain wave alpha band power spectrum density and improve postoperative cognitive function in older adults undergoing lower extremity fractures surgeries.Keywords: brain waves, alpha band, benzodiazepines, remimazolam, cognitive dysfunction, elderly, neuropsychological tests
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spelling doaj-art-be2324c8ddbd4ddaa973ae12e9e2fa232025-01-02T17:00:45ZengDove Medical PressClinical Interventions in Aging1178-19982024-12-01Volume 192195220598873Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled TrialWu HTian SMa HZhou WFeng SMeng LOu JXu FZhang ZHao Wu,1,&ast; Shunping Tian,1,&ast; Hongxia Ma,2,&ast; Wei Zhou,1 Shantian Feng,1 Lijun Meng,3 Jinlei Ou,3 Fei Xu,1 Zhuan Zhang1 1Department of Anesthesiology, The Affiliated Hospital of Yangzhou University, Yangzhou, 225012, People’s Republic of China; 2Department of Anesthesiology, The Second People’s Hospital of Lianyungang, Lianyungang, 222023, People’s Republic of China; 3Intensive Care Unit, The Affiliated Hospital of Yangzhou University, Yangzhou, 225012, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Zhuan Zhang, Department of Anesthesiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu, 225012, People’s Republic of China, Tel +86 15062791355, Email zhangzhuancg@163.comPurpose: Low density of electroencephalogram alpha band power was reported to be associated with perioperative cognitive dysfunction. Few studies have conducted to explore the effects of remimazolam on intraoperative frontal alpha band power spectrum density in older adults. Here, we aimed to explore the impact of remimazolam on intraoperative frontal brain wave alpha band activity and postoperative cognitive function in older adults undergoing lower extremity fractures surgeries.Methods: Patients undergoing elective general anesthesia for lower extremity fracture surgery were randomly allocated to remimazolam group (Group R) and midazolam group (Group M). Group R was induced with remimazolam bolus 0.1 mg/kg followed by a maintenance dose of 0.1 mg·kg− 1·h− 1 for general anesthesia. Group M was induced with midazolam 0.05 mg/kg followed by normal saline maintenance of 0.1 mL·kg− 1·h− 1. The rest anesthesia protocol was the same for both groups. Electroencephalogram data was recorded before anesthesia induction till the end of surgery. Cognitive function was assessed preoperatively, and at the first, third, fifth, and seventh day postoperatively.Results: Compared with Group M, Group R had significantly higher intraoperative power spectral density of the frontal alpha band (P < 0.001), and significantly lower incidence of postoperative cognitive dysfunction at T8 and T9 (P = 0.031 and P = 0.017, respectively).Conclusion: Remimazolam can increase frontal brain wave alpha band power spectrum density and improve postoperative cognitive function in older adults undergoing lower extremity fractures surgeries.Keywords: brain waves, alpha band, benzodiazepines, remimazolam, cognitive dysfunction, elderly, neuropsychological testshttps://www.dovepress.com/effects-of-remimazolam-on-intraoperative-frontal-alpha-band-power-spec-peer-reviewed-fulltext-article-CIAbrain wavesalpha bandbenzodiazepinesremimazolamcognitive dysfunctionelderlyneuropsychological tests
spellingShingle Wu H
Tian S
Ma H
Zhou W
Feng S
Meng L
Ou J
Xu F
Zhang Z
Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial
Clinical Interventions in Aging
brain waves
alpha band
benzodiazepines
remimazolam
cognitive dysfunction
elderly
neuropsychological tests
title Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial
title_full Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial
title_fullStr Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial
title_full_unstemmed Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial
title_short Effects of Remimazolam on Intraoperative Frontal Alpha Band Power Spectrum Density and Postoperative Cognitive Function in Older Adults Undergoing Lower Extremity Fractures Surgeries: A Randomized Controlled Trial
title_sort effects of remimazolam on intraoperative frontal alpha band power spectrum density and postoperative cognitive function in older adults undergoing lower extremity fractures surgeries a randomized controlled trial
topic brain waves
alpha band
benzodiazepines
remimazolam
cognitive dysfunction
elderly
neuropsychological tests
url https://www.dovepress.com/effects-of-remimazolam-on-intraoperative-frontal-alpha-band-power-spec-peer-reviewed-fulltext-article-CIA
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