Objective To investigate the effect and safety of different infusion rates of remimazolam in induction of general anesthesia.

Methods Eighty patients undergoing elective gynecological surgery under general anesthesia were selected, and were randomly divided into group A given intravenous infusion of remazolam for 3 mg/(kg·h) to induce anesthesia and group B receiving intravenous infusion of remazolam for 6 mg/(kg·h) to induce anesthesia, with 40 cases per group. After consciousness disappeared, patients were given endotracheal intubation after successively infusion of cisatracurium besilate and sufentanil, followed by pump injection of remazolam and remifentanil to maintain anesthesia, and bispectral index (BIS) value of 40 to 60 were maintained. The changes of systolic blood pressure (SBP), heart rate (HR) and BIS were recorded before induction (T₀), at the time of consciousness disappearance (T₁), before intubation (T₂), 1 min after intubation (T₃), and 5 min after intubation (T₄); induction dose, time of loss of consciousness (LoC), induction success rate, the number of pain cases at the injection site, the number of hiccup cases, the number of hypotension, hypertension and bradycardia cases during induction and awakening time were recorded.

Results Compared with T₀, the SBP and BIS values of patients in both groups at T₁ to T₄ were significantly lower, and the values of HR in both groups at T₂ and T₄ were significantly lower (P < 0.05); there were no significant differences in SBP, HR, BIS value and the incidence of hypotension, hypertension, bradycardia and pain of injection site between the group A and group B at each time point (P>0.05). In group A, the time of LoC was slightly prolonged, but the induction dose was reduced, the incidence of hiccup during induction was decreased(P < 0.05).

Conclusion Remimazolam at infusion rate of 3 mg/(kg·h) is safer and more effective during induction of general anesthesia.