IJMABHR International Journal of Medical and All Body Health ResearchIJMABHR 2582-8940 Anfo Publication House 382 10.54660/IJMBHR.2025.6.3.186-192 Hypotension after General Anesthesia Induction with Remimazolam or Propofol in Geriatric Patients Undergoing Sevoflurane Anesthesia with Remifentanil BhartiAman JagarKeshav Dev SharmaShailja SharmaNikhil BhatiBobi 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 25072025 6 3 186 192 13062025 15072025 CC BY-NC-SA 4.0

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 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

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