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Background: Remimazolam and dexmedetomidine are commonly used as sedatives. However, the effects and safety of remimazolam alone or in combination with dexmedetomidine have not been investigated., Aim: We sought to investigate the clinical effects of remimazolam alone or in combination with dexmedetomidine in bronchoscopy, and their influence on cognitive function., Method: Ninety eligible patients who underwent bronchoscopy under intravenous anesthesia were randomly divided into three groups: propofol control, remimazolam, and remimazolam plus dexmedetomidine. The primary outcome was the incidence of perioperative hypoxemia. Secondary outcomes included induction and maintenance doses of remimazolam, hemodynamic variables, scores for modified Observer's Assessment of Alertness/Sedation (MOAA/S), coughing, limb movement, incidence of adverse events, patient satisfaction, bronchoscopist satisfaction, incidence of post-operative cognitive dysfunction (POCD), time to loss of consciousness (LoC), and time to awake., Results: The incidence of hypoxemia, hypotension, and bronchoscopist satisfaction score were significantly decreased, and time to LoC and time to awake were markedly longer in the remimazolam and remimazolam plus dexmedetomidine groups than in the propofol control group (p < 0.05). The remimazolam group had significantly decreased induction and maintenance doses of remimazolam and a shorter time to LoC than the remimazolam plus dexmedetomidine group (p < 0.05). Scores for coughing, limb movement, MOAA/S, and post-operative patient satisfaction were comparable among the three groups. POCD was not induced in any of the groups., Conclusion: Remimazolam is safe and effective for painless bronchoscopy, with a low incidence of adverse reactions, and exhibits a good synergistic effect with dexmedetomidine., Trial Registration: This trial protocol had been registered on Chinese Clinical Trial Registry (ChiCTR2000041435, date: 2020 12 26., (© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

This paper aimed to explore dexmedetomidine combined local anesthetics in brachial plexus block through ultrasound imaging (UI) under global joint entropy algorithm. Patients who underwent upper limb surgery and brachial plexus block were selected as research objects. Patients in group A were given 0.375% ropivacaine and normal saline, and patients in group B were given 0.375% ropivacaine and 1.0 μg/kg dexmedetomidine. The results of UI were analyzed by global joint entropy-based K-means clustering (GKC) algorithm, and the use effects of the two methods were compared in combination with other postanesthesia manifestations. The results were as follows. The segmentation accuracy (96.21% and 83.52%) of GKC was higher than 82.21% and 70.52% of the local joint entropy-based K-means clustering (LKC) (P < 0.05). The duration of sensory and motor block (352.78 ± 45.89 min and 324.38 ± 41.29 min) in group B was significantly longer than 292.28 ± 35.69 min and 256.58 ± 42.76 min in group A (P < 0.05). Compared with 84.91 ± 8.77 beats/min and 89.58 ± 7.62 beats/min in group A, mean arterial pressure (70.24 ± 9.77 beats/min and 69.89 ± 8.97 beats/min) in group B was lower at T1 and T2 (P < 0.05). The duration of postoperative pain (582.70 ± 51.89 min) in group B was longer than 372.89 ± 49.89 min in group A (P < 0.05). The postoperative pain score (2.98 ± 1.08) in group B was significantly lower than 4.48 ± 2.19 in group A (P < 0.05). Therefore, dexmedetomidine combined local anesthetics could prolong the duration of sensory and motor nerve block. Besides, dexmedetomidine had sedative and analgesic effects, so as to prolong postoperative pain time and reduce pain degree of patients. [ABSTRACT FROM AUTHOR]