Efficacy and Safety of Remimazolam Tosilate Combined with Sufentanil for Outpatient Painless Abortion: A Randomized, Double-blind, Prospective Trial

iObjective/ii: /iTo investigate the anesthetic effect and safety of remimazolam tosilate combined with sufentanil in outpatient painless abortion. iMethods/ii: /iFrom September 2025 to October 2025, 140 patients aged 18-50 years, body mass index (BMI) 18.5-28kg / msup2/sup, American Society of Anesthesiologists (ASA) grade I-II, who underwent painless abortion in the outpatient department were selected. The patients were randomly divided into two groups: remimazolam tosilate group (group R, n = 70) and control group (group C, n = 70). Sufentanil 0.1 μg / kg was intravenously injected for analgesia pretreatment in both groups before operation. Patients in group R were intravenously injected with 0.2 mg / kg of remimazolam tosilate during anesthesia induction, and patients in group C were intravenously injected with 2 mg / kg of propofol medium and long chain fat emulsion during anesthesia induction. The main observation index was the incidence of respiratory depression. The secondary observation indexes included numerical rating scales (NRS) pain score, onset time, recovery time, Post-Anesthesia Care Unit (PACU) stay time, remedial drug use rate and incidence of adverse reactions when entering the anesthesia recovery room. iResults/ii: /iA total of 140 patients were included in the analysis of results. Compared with group C, the incidence of respiratory depression was lower in group R (1.4% vs 15.7%, P = 0.003), and the postoperative recovery time was shorter (P = 0.010), but the use rate of secondary rescue sedatives was higher. There was no significant difference in the onset time, duration of operation, PACU stay time, intraoperative sufentanil dosage, incidence of adverse reactions, and degree of pain in PACU between the two groups. The adverse reactions in group R were mainly manifested as body movement, and the adverse reactions in group C were mainly manifested as procedural hypotension, injection pain and respiratory depression. There was no significant difference in adverse reactions such as dizziness, intraoperative awareness, bradycardia and nausea and vomiting between the two groups. iConclusion/ii: /iRemimazolam tosilate combined with sufentanil is safe and effective in outpatient painless abortion patients. Its core advantages are low risk of respiratory depression, rapid recovery, stable hemodynamics, and no common injection pain of propofol. It is highly adapted to the efficiency and safety requirements of outpatient diagnosis and treatment, and has important clinical promotion value.