Effect of the of remazolam toluenesulfonate and IPACK on postoperative rehabilitation and sedation in elderly patients undergoing knee arthroplasty

Purpose: To investigate the effect of the combination of remazolam toluenesulfonate and infiltration between the popliteal artery and capsule of the knee (IPACK) on the rehabilitation and sedation of elderly patients undergoing knee arthroplasty. Methods: A total of 84 elderly patients who underwent knee arthroplasty in Quzhou Affiliated Hospital of Wenzhou Medical University between January 2021 and December 2021 were given IPACK in combination with adductor canal block under ultrasound guidance. Forty (40) patients were given anesthesia with propofol + sufentanil + cis-benzene sulfonic acid atracurium (control group), while 44 patients received anesthesia with remazolam toluenesulfonate + sufentanil + cis-benzene sulfonic acid atracurium (study group). Various clinical indices in the patients were assessed Results: Relative to control, there were significantly lower visual analog scale (VAS) scores at 6 and 12 h after operation, lower frequency of post-operation pumping with PCA pump, lower frequency of remedial analgesia within 48 h after operation (p < 0.05). Moreover, the time taken for spontaneous recovery of breathing, recovery time, and extubation time were similar in the two groups (p > 0.05). The muscle strength of quadriceps femoris of the affected knee joint was higher in the study group than in the control group at 12, 24, and 48 h, after operation (p < 0.05). Conclusion: The combination of remazolam toluenesulfonate with IPACK effectively alleviate pain in elderly patients undergoing knee arthroplasty and improves sedation without increasing cognitive dysfunction. This treatment strategy has potentials for further investigation for possible large-scale application.