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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

168 cm

Weight

55 kg

Body mass index

19.6 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

腹腔镜下直肠根治术

3.Intraoperative indicators
3.1.systolic pressure

Baseline

153 mmHg

Induction time

135 mmHg

3 minutes after administration

127 mmHg

Immediately after intubation

130 mmHg

10 minutes after administration

109 mmHg

3.2.diastolic pressure

Baseline

68 mmHg

Induction time

93 mmHg

3min after administration

87

Immediately after intubation

65 mmHg

10min after administration

73 mmHg

3.3.Heart rate

Baseline

80 次/分

Induction time

84 次/分

3min after administration

79 次/分

Immediately after intubation

78 次/分

10min after administration

70 次/分

3.4.Bispectral index

Baseline

98

Induction time

54

3min after administration

43

5min after administration

40

10min after administration

41

3.5.Operation duration

Operation duration

1 H

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

The infusion speed for maintaining general anesthesia with relevant drugs

3.6 mg/kg/h

The infusion speed maintained by remifentanil general anesthesia

0.3 ug/kg/min

The average infusion rate maintained by general anesthesia with norepinephrine

3.6 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

30 s

4.2.Occurrence of adverse reactions during induction

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

1

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

0.2 mg

Total usage of Remazolam

200 mg

Total use of propofol

0 mg

Total use of remifentanil

1 mg

4.5.Quality of Awakening

Whether agitation occurs during the wake perio

No

extubation time

10 min

PACU stay time

27 min

4.6.The correlation between remazolam and bis

T0(Baseline) bis value

98

T1(induction time)bis value

54

T2(5min after induction)bis value

40

T3 (10min after induction)bis value

41

T4(at the end of the operation) bis value

64

T5(The lowest) bis value

40

5.Follow-up
5.1.

Concise Mental State Scale Score

27

5.2.Recovery quality assessment

Total score of qor-40 scale

91

Emotional state score

18

Physical Comfort Score

22

Psychological support score

31

Self-care score

13

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

0

48h postoperative pain numerical score

0

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