Protocol
postoperative pain, postoperative nausea and vomiting, µg*kgAfter loss of consciousness
Assessment of eligibility and enrollment in the study was performed by the corresponding author. The participants were informed about the study via an informed consent form the day before the surgery, and provided sufficient time to determine their participation and sign the form. The participants were randomly assigned (1:1) to the propofol or remimazolam groups, namely groups P and R, respectively, using a sealed envelope system. A random allocation sequence was generated in advance by one of the authors (SWS) using R software. Paper cards containing the group allocations were sealed in opaque envelopes. Each sealed envelope was opened by another author (SK), and the patient notified the group allocation to an attending anesthesiologist 30 min before surgery. No anesthetic premedication was administered to the participants. The routine administration of ACEI or ARB was continued on the day of surgery.The induction drug was drawn in the anesthesia preparation room and the syringe was placed in a metal tin box. The patient and surgeon were blinded to the bolus drug administered by placing an opaque plastic cardboard, and blinding was maintained until the discharge of the patient from the post-anesthetic care unit.The baseline blood pressure, heart rate, pulse oximetry, and BIS (BIS Complete Monitoring system, Covidien Ireland Limited, Dublin, Ireland) were recorded following the patient identification process. Other standard anesthetic monitoring devices, such as electrocardiograms, were also applied. Remifentanil infusion was initiated at a rate of 0.25 µg*kgAfter loss of consciousness, remimazolam was infused at a rate of 1 mg*kgAn additional bolus of rocuronium 0.15 mg/kg IBW was administered in cases of decreased pulmonary compliance or discretion of the surgeon. Fentanyl 1 µg/kg and ramosetron 0.3 mg were administered for postoperative pain control and postoperative nausea and vomiting prophylaxis.