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1.Screening
1.1.Inclusion Criteria

Age 60-80 years old, gender unlimited;

Yes

Patients undergoing gastrointestinal surgery under selective tracheal intubation and general anesthesia; Duration of operation 4h;

Yes

ASA grades Ⅱ to Ⅲ

Yes

BMI 18-30kg/m2

Yes

Voluntarily sign informed consent

Yes

1.2.Exclusion Criteria

Being deaf and mute, she is unable to communicate verbally

No

Patients with difficult airway were modified for Mallampati grade IV

No

Preoperative delirium or dementia

No

Preoperative history of severe cardiovascular disease and uncontrollable diabetes; Serious injury or disease of vital organs such as the lungs, brain, liver or kidneys

No

Patients with severe consciousness disorder or mental system disease (schizophrenia, mania, insanity, etc.) and cognitive dysfunction

No

Intolerance or allergy to benzodiazepines

No

A history of alcoholism; And a history of drug addiction or other substance abuse

No

1.3.Criteria for dropout/withdrawal cases

The patient voluntarily withdrew the informed consent

No

No follow-up, no efficacy and safety data were collected

No

The investigator ordered them to withdraw: patients with unanticipated difficulty with mask ventilation or tracheal intubation

No

1.4.Exclusion criteria for cases

Violation of the entry standard

No

Inadequate or missing medical records

No

2.Baseline

Age

60

Gender

1

Height

170 cm

Weight

57 kg

Body mass index

19.7 kg/m2

ASA classification

Underlying disease

0

2.1.Age
2.2.Gender
2.3.Height
2.4.Weight
2.5.Body mass index
2.6.ASA classification
2.7.Underlying disease
2.2.7.2.7.1、hypertension

hypertension

No

2.2.7.2.7.2、diabetes

diabetes

No

2.8.Surgical name

Surgical name

腹腔镜下右半结肠切除术

3.Intraoperative indicators
3.1.systolic pressure

Baseline

144 mmHg

Induction time

121 mmHg

3 minutes after administration

103 mmHg

Immediately after intubation

128 mmHg

10 minutes after administration

114 mmHg

3.2.diastolic pressure

Baseline

63 mmHg

Induction time

57 mmHg

3min after administration

52

Immediately after intubation

50 mmHg

10min after administration

60 mmHg

3.3.Heart rate

Baseline

65 次/分

Induction time

55 次/分

3min after administration

62 次/分

Immediately after intubation

73 次/分

10min after administration

51 次/分

3.4.Bispectral index

Baseline

92

Induction time

49

3min after administration

45

5min after administration

43

10min after administration

42

3.5.Operation duration

Operation duration

4 H

3.6.The infusion speed for maintaining general anesthesia with relevant drugs

The infusion speed for maintaining general anesthesia with relevant drugs

3.5 mg/kg/h

The infusion speed maintained by remifentanil general anesthesia

0.4 ug/kg/min

The average infusion rate maintained by general anesthesia with norepinephrine

3.7 ug/kg/h

4.Intraoperative secondary indicators
4.1.The time of onset of sedation until loss of consci

The time of onset of sedation until loss of consciousness

24 s

4.2.Occurrence of adverse reactions during induction

Hypotension (systolic blood pressure <90mmHg, or a decrease of more than 20% from baseline)

3

Bradycardia (heart rate <50 beats/min)

0

Injection pain

No

4.3.Induction success rate of general anesthesia

General anesthesia induction successful

Yes

4.4.Total Drug Usage

Total use of the vasoactive drug deoxyadrenaline during induction

0 ug

Total norepinephrine use during maintenance of general anesthesia

0.9 mg

Total usage of Remazolam

0 mg

Total use of propofol

860 mg

Total use of remifentanil

6 mg

4.5.Quality of Awakening

Whether agitation occurs during the wake perio

No

extubation time

12 min

PACU stay time

50 min

4.6.The correlation between remazolam and bis

T0(Baseline) bis value

92

T1(induction time)bis value

49

T2(5min after induction)bis value

43

T3 (10min after induction)bis value

42

T4(at the end of the operation) bis value

72

T5(The lowest) bis value

42

5.Follow-up
5.1.

Concise Mental State Scale Score

27

5.2.Recovery quality assessment

Total score of qor-40 scale

77

Emotional state score

18

Physical Comfort Score

23

Psychological support score

19

Self-care score

10

pain score

7

5.3.Incidence of nausea and vomiting

The frequency of nausea within three days after surgery

0

The frequency of vomiting within three days after surgery

0

5.4.Pain measurement

24h postoperative pain numerical score

3

48h postoperative pain numerical score

1

72h postoperative pain numerical score

0

5.5.Incidence of delirium

Occurrence of delirium 24 hours after surgery(3D-CAM scale)

No

Occurrence of delirium 48 hours after surgery(3D-CAM scale)

No

Occurrence of delirium 72h after surgery(3D-CAM scale)

No

Occurrence of delirium 96h after surgery

Yes
/
No

Occurrence of delirium 120h after surgery

No

5.6.Onset and duration of delirium

Time of onset of delirium

0 day

Duration of delirium

0 day