The Application of Remimazolam Toluene Sulfonate with Propofol in Orthotopic Liver Transplantation

The objective of the study is to explore the application value of remimazolam toluene sulfonate in orthotopic liver transplantation. A total of 120 patients who underwent orthotopic liver transplantation in our hospital from March 2021 to December 2022 were randomized into intervention group (R group, n=60, remimazolam toluene sulfonate) and control group (C group, n=60, normal saline). For induction of anesthesia, all patients were administrated with propofol intravenously, study drug (0.2 ml/kg), sufentanil and cisatracurium. Intraoperative infusion of propofol and study drug was used to maintain sedation. All patients returned to intensive care unit to continue infusion for sedation after orthotopic liver transplantation. The dose of propofol, cumulative duration of intraoperative hypertension and dose of norepinephrine were significantly less than those in control group, p<0.05. At d 1 after surgery, alanine transaminase, aspartate aminotransferase, total bilirubin, direct bilirubin and creatinine in intervention group were significantly lower than those in control group, p<0.05; at d 2 after surgery, alanine transaminase, aspartate aminotransferase, total bilirubin, direct bilirubin and creatinine in intervention group were significantly lower than those in control group, p<0.05. 3rd after surgery, aspartate aminotransferase in intervention group was significantly lower than that in control group, p<0.05. The albumin-bilirubin score, incidences of postoperative early allograft dysfunction and delirium and duration of cannulation were not significantly different among two groups, p>0.05. Remimazolam toluene sulfonate can stabilize perioperative hemodynamics and reduce hypertension, thus can be used in liver transplantation and preserve early liver graft function after orthotopic liver transplantation.