Abstract: Objective The aim of this study was to investigate remimazolam and low-dose of propofol combination in induction of general anesthesia in patients with primary liver cancer (PLC) undergoing hepatectomy. Methods 80 patients with PLC were encountered in our hospital between January 2020 and January 2024, and all underwent hepatectomy. For induction of anesthesia, we assigned patients into group A (n=40), receiving combination agents, and group B (n=40), receiving remimazolam and low-dose of propofol, intravenously. All patients received routine anesthesia maintenance. Before anesthesia induction (T₀), after anesthesia induction (T₁), at intubation (T₂) and at end of surgery (T₃), sedation and postoperative cognitive function were evaluated by using Riker sedation/anxiety scale (SAS) and mini mental state examination (MMSE) scale. Results There was no significant differences in eye-opening time, extubation time and post-anesthesia care unit stay between the two groups (P>0.05); by T₂, mean arterial pressure and heart rate in group B were(80.1±7.5)mmHg and (71.9±8.1)beats/min, both significantly lower than [(84.5±8.3)mmHg and (76.7±8.0)beats/min, respectively, P<0.05] in group A; by 1 min, 5 min and 10 min after removal of tracheal catheter, SAS scores in group B were (3.2±0.4)points, (3.6±0.5)points and (3.7±0.6)points, all significantly lower than [(3.9±0.7)points, (4.2±0.8)points and (4.5±0.9)points, respectively, P<0.05] in group A; by 6 hours after operation, MMSE score in group B was (25.7±3.0)points, much higher than [(22.5±2.1)points, P<0.05] in group A; post-operationally, adverse effect in group B was 2.5%, much lower than 17.5%(P<0.05) in group A. Conclusion Combination of remimazolam and low-dose of propofol in induction of general anesthesia in patients with PLC undergoing hepatectomy could maintain hemodynamic stability, improve sedation and cognitive function restoration.

Key words: Hepatoma, Hepatectomy, Induction of general anesthesia, Remimazolam, Propofol, Anesthesia