Effects of remimazolam tosylate combined with sufentanil on postoperative cellular immune function, recovery quality, and pulmonary complications in elderly patients undergoing laparoscopic cholecystectomy

doi:10.3877/cma.j.issn.2095-2015.2026.05.013

Abstract

Abstract:

Objective

To investigate the effects of remimazolam tosylate combined with sufentanil on postoperative cellular immune function, recovery quality, and pulmonary complications (PPCs) in elderly patients undergoing laparoscopic cholecystectomy (LC).

Methods

A total of 90 elderly patients with LC who were admitted to No.215 Hospital of Shaanxi Nuclear Industry from January 2024 to June 2025 were selected and randomly divided into a control group and an observation group, with 45 cases in each group. The control group received sufentanil anesthesia, while the observation group received combined remimazolam tosylate anesthesia. The awakening quality (recovery time, spontaneous breathing recovery time, extubation time), the changes in T lymphocyte levels (CD3⁺, CD4⁺, CD8⁺), serum-related indicators [adrenocorticotropic hormone (ACTH), 5-hydroxytryptamine (5-HT), substance P (SP)], and inflammatory factors [interleukin 6 (IL-6), C-reactive protein (CRP)], tumor necrosis factor α (TNF-α)] before and 24 hours after the operation, as well as the occurrence of PPCs within 7 days after the operation were compared between the two groups.

Results

The anesthesia recovery time, the time for spontaneous breathing restoration, and the extubation time in the observation group were all shorter than those in the control group (P<0.05). At 24 hours after the operation, CD3⁺ and CD4⁺ in both groups decreased prominently, while the CD8⁺, levels of serum ACTH, 5-HT, SP, IL-6, CRP and TNF-α increased prominently. However, CD3⁺ and CD4⁺ in the observation group were higher than those in the control group, while the CD8⁺, levels of serum ACTH, 5-HT, SP, IL-6, CRP and TNF-α were lower than those in the control group (P<0.05). The observation group had a lower incidence of PPCs than the control group (P<0.05).

Conclusion

The combination of remimazolam tosylate and sufentanil in the anesthesia of elderly patients undergoing LC has a better effect. It is more conducive to regulating T lymphocyte subsets and improving the quality of recovery, reducing stress and inflammatory responses, and lowering the incidence of PPCs.

Key words: Laparoscopic cholecystectomy, Remimazolam tosylate, Sufentanil, Awakening quality

Xinyang Zhang, Liuqin Jiang, Le Jin. Effects of remimazolam tosylate combined with sufentanil on postoperative cellular immune function, recovery quality, and pulmonary complications in elderly patients undergoing laparoscopic cholecystectomy[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2026, 16(05): 469-473.

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References 22

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指标	观察组(n=45)	对照组(n=45)	t/χ²值	P值
年龄(岁)	71.44±6.28	71.16±6.35	0.210	0.834
体重指数(kg/m²)	22.89±2.38	23.05±2.31	0.324	0.747
性别[例(%)]
男	27(60.00)	24(53.33)	0.407	0.523
女	18(40.00)	21(46.67)	0.407	0.523
美国麻醉医师协会分级[例(%)]
Ⅰ级	25(55.56)	23(51.11)	0.179	0.673
Ⅱ级	20(44.44)	22(48.89)	0.179	0.673
疾病类型[例(%)]
胆囊结石伴息肉	15(33.33)	17(37.78)	1.265	0.531
胆囊息肉	12(26.67)	15(33.33)
胆囊结石	18(40.00)	13(28.89)

指标	观察组(n=45)	对照组(n=45)	t/χ²值	P值
年龄(岁)	71.44±6.28	71.16±6.35	0.210	0.834
体重指数(kg/m²)	22.89±2.38	23.05±2.31	0.324	0.747
性别[例(%)]
男	27(60.00)	24(53.33)	0.407	0.523
女	18(40.00)	21(46.67)	0.407	0.523
美国麻醉医师协会分级[例(%)]
Ⅰ级	25(55.56)	23(51.11)	0.179	0.673
Ⅱ级	20(44.44)	22(48.89)	0.179	0.673
疾病类型[例(%)]
胆囊结石伴息肉	15(33.33)	17(37.78)	1.265	0.531
胆囊息肉	12(26.67)	15(33.33)
胆囊结石	18(40.00)	13(28.89)

组别	例数	苏醒时间	自主呼吸恢复时间	拔管时间
观察组	45	9.84±1.76	7.36±1.25	11.78±2.21
对照组	45	11.35±1.82	8.67±1.38	14.02±2.57
t值		4.001	5.044	4.433
P值		<0.001	<0.001	<0.001

组别	例数	苏醒时间	自主呼吸恢复时间	拔管时间
观察组	45	9.84±1.76	7.36±1.25	11.78±2.21
对照组	45	11.35±1.82	8.67±1.38	14.02±2.57
t值		4.001	5.044	4.433
P值		<0.001	<0.001	<0.001

组别	例数	CD3⁺(%)		CD4⁺(%)		CD8⁺(%)
组别	例数	术前	术后24 h	术前	术后24 h	术前	术后24 h
观察组	45	72.17±7.78	67.12±7.04^#	44.51±6.17	40.32±5.41^#	25.86±4.74	29.25±4.87^#
对照组	45	71.69±7.85	62.57±6.33^#	44.02±6.04	36.28±5.03^#	25.41±4.62	33.72±5.01^#
t值		0.291	3.224	0.381	3.669	0.456	4.292
P值		0.771	0.002	0.704	<0.001	0.649	<0.001

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