International Journal of Medical and All Body Health Research  |  e-ISSN: 2582-8940  |  Double-Blind Peer Review  |  Open Access  |  CC BY-NC-SA 4.0

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     2026:7/4

International Journal of Medical and All Body Health Research

e-ISSN: 2582-8940 | Open Access

Hypotension after General Anesthesia Induction with Remimazolam or Propofol in Geriatric Patients Undergoing Sevoflurane Anesthesia with Remifentanil

Dr. Aman Bharti, Dr. Keshav Dev Jagar, Dr. Shailja Sharma, Dr. Nikhil Sharma, Dr. Bobi Bhati

Post Graduate, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Associate Professor, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; HOD, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India; Post Graduate Resident, Department of Anaesthesia and Critical Care, Saraswathi Institute of Medical Sciences, Pilkhuwa, Hapur, Uttar Pradesh, India

Article Information

Volume / Issue6 / 3 (July-September 2025)
Pages186-192
AccessOpen Access

Publication Timeline

  • Received13 June 2025
  • Accepted15 July 2025
  • Published

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Abstract

Hemodynamic instability, particularly hypotension, remains a significant concern during anesthesia induction in geriatric patients. This study compared the incidence and severity of post-induction hypotension between remimazolam and propofol in elderly patients undergoing sevoflurane-based general anesthesia with remifentanil. A prospective, randomized, double-blind study was conducted involving 180 patients aged ≥65 years scheduled for elective surgery under general anesthesia. Patients were randomly allocated to receive either remimazolam (0.3 mg/kg) or propofol (1.5 mg/kg) for anesthesia induction, followed by sevoflurane maintenance with remifentanil infusion. Primary outcome was the incidence of hypotension (systolic blood pressure <90 mmHg or >30% decrease from baseline) within 10 minutes post-induction. Secondary outcomes included hemodynamic parameters, vasopressor requirements, and adverse events. The incidence of post-induction hypotension was significantly lower in the remimazolam group compared to the propofol group (32.2% vs 57.8%, p<0.001). Mean arterial pressure decreased by 18.5±8.2% in the remimazolam group versus 28.7±11.4% in the propofol group (p<0.001). Vasopressor requirement was reduced by 40% in the remimazolam group. Time to loss of consciousness was comparable between groups (98±23 s vs 94±21 s, p=0.312). Remimazolam demonstrated superior hemodynamic stability compared to propofol during anesthesia induction in geriatric patients, with significantly reduced incidence of hypotension and vasopressor requirements while maintaining comparable efficacy.

Keywords

RemimazolamPropofolHypotensionGeriatric AnesthesiaSevofluraneRemifentanilHemodynamic Stability

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How to Cite

Bharti, A., Jagar, K. D., Sharma, S., Sharma, N., & Bhati, B. (2025). Hypotension after General Anesthesia Induction with Remimazolam or Propofol in Geriatric Patients Undergoing Sevoflurane Anesthesia with Remifentanil. International Journal of Medical and All Body Health Research, 6(3), 186-192. https://doi.org/10.54660/IJMBHR.2025.6.3.186-192

Bharti, Aman, et al. "Hypotension after General Anesthesia Induction with Remimazolam or Propofol in Geriatric Patients Undergoing Sevoflurane Anesthesia with Remifentanil." International Journal of Medical and All Body Health Research, vol. 6, no. 3, 2025, pp. 186-192. https://doi.org/10.54660/IJMBHR.2025.6.3.186-192.

Bharti, A., Jagar, K. D., Sharma, S., Sharma, N. and Bhati, B. (2025) 'Hypotension after General Anesthesia Induction with Remimazolam or Propofol in Geriatric Patients Undergoing Sevoflurane Anesthesia with Remifentanil', International Journal of Medical and All Body Health Research, 6(3), pp. 186-192. doi: 10.54660/IJMBHR.2025.6.3.186-192.

Bharti A, Jagar KD, Sharma S, Sharma N, Bhati B. Hypotension after General Anesthesia Induction with Remimazolam or Propofol in Geriatric Patients Undergoing Sevoflurane Anesthesia with Remifentanil. International Journal of Medical and All Body Health Research. 2025;6(3):186-192. doi:10.54660/IJMBHR.2025.6.3.186-192

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