Abstract:Objective To compare the anesthesia effect and hemodynamics of remimazolam versus propofol in combination with remifentanil in hysteroscopic surgery. Methods A total of 60 patients who underwent elective hysteroscopic endometrial dissection due to abnormal uterine bleeding and endometrial thickening in Qingdao Municipal Hospital from April to December 2022 were randomly divided into observation group (n=30) and control group (n=30). Propofol combined with remifentanil for anesthesia induction and maintenance was given in the control group, and remimazolam combined with remifentanil for anesthesia induction and maintenance was given in the observation group. The hemodynamic indexes, anesthesia effect and adverse reactions of patients were compared between the two groups at the following 6 time points: before anesthesia induction (T₁), when inserting a laryngeal mask (T₂), 5 min before the start of surgery (T₃), immediately after the start of surgery (T₄), 5 min before removing the laryngeal mask (T₅), and immediately after removing the laryngeal mask (T₆). Results The mean arterial pressure at T₂, T₃, T₄, T₅ and T₆ and heart rate at T₂ in the observation group were higher than those in the control group, with statistically significant differences (P＜0.05). Compared with the control group, the observation group had a longer time for disappearance of eyelash reflexes (P＜0.05). There was no significant difference in the anesthesia recovery time between the two groups (P＞0.05). The incidences of injection pain (0 vs 56.67%, χ²=23.721) 〖JP+1〗and hypotension (23.33% vs 56.67%, χ²=〖JP〗〖LM〗6.944) in the observation group was lower than that in the control group, with statistically significant differences (P<0.01). Conclusion Compared with propofol, the induction and maintenance of anesthesia with remimazolam combined with remifentanil during hysteroscopic surgery can reduce the impact on the hemodynamics of patients and reduce the incidence of adverse reactions.