Remiazolam vs Propofol Total Intravenous Anesthesia on Postoperative Neurodevelopment After General Anesthesia in Children

Inclusion criteria

• Age: 3-6 years old;
• Planned to undergo elective non-neurological, non-cardiac, and non-liver surgery under general anesthesia (abdominal surgery, orthopedic surgery, urological surgery, otolaryngological surgery, etc.);
• Expected anesthesia duration to be more than 30 minutes;
• ASA classification I-II;
• BMI 14-25 kg/m2;
• Postoperative plan not to be admitted to ICU;
• Parents or legal guardians of the child have given informed consent;
• Capable of communicating in Chinese.

Exclusion criteria

• Those who were exposed to general anesthetic drugs during infancy or in the late pregnancy of the mother;
• Known chromosomal abnormalities or other known acquired or congenital diseases that may affect neural development, such as cerebral palsy, autism spectrum disorder or attention deficit hyperactivity disorder (ADHD), etc.;
• Patients with severe liver dysfunction (Child-Pugh C grade);
• Patients with severe kidney dysfunction (requiring dialysis before surgery);
• Patients with a history of congenital heart disease requiring surgery or drug treatment;
• Those allergic to the study drugs remimazolam or propofol;
• Any known neural damage, such as cystic periventricular leukomalacia or grade 3 or 4 intraventricular hemorrhage;
• Social or geographical factors that may lead to postoperative loss of follow-up;
• Planned to undergo two surgeries within 7 days after the surgery;
• Those currently participating in other clinical trials;
• Those receiving special care or living in social welfare institutions or any other factors that may affect their ability to participate in the study.