ObjectiveTo explore the effect of remimazolam besylate combined with alfentanil on hemodynamics, anesthetic recovery, analgesic and sedative effect in patients undergoing daytime thyroidectomy. MethodsThe clinical data of 108 patients who underwent daytime thyroidectomy were analyzed retrospectively, and patients were assigned to study group or control group according to anesthetic methods, with 54 cases in each group. Both groups received orotracheal intubation total intravenous anesthesia, and anesthetic induction drugs were remimazolam besylate+alfentanil hydrochloride+cisatracurium besylate, and propofol+alfentanil hydrochloride+cisatracurium besylate for the study group and the control group, respectively; furthermore, the anesthetic maintenance drugs were remimazolam besylate+alfentanil hydrochloride, and propofol+alfentanil hydrochloride for the study group and the control group, respectively. Hemodynamic indices before operation (T0), at incision (T1), at 15 minutes after the beginning of operation (T2), at goitre removing (T3), and in the end of operation (T4), anesthetic recovery (time to open eyes, time to regain consciousness, tracheal extubation time, length of stay in the recovery room), and the Numerical Rating Scale （NRS） score, Ramsay sedation score after 1, 3, 6, and 12 hours of operation, as well as the occurrence of adverse reactions were compared between patients of the two groups. Results(1) At T1, T2, T3, and T4, both groups exhibited higher systolic pressure, diastolic pressure, and heart rate as compared with T0, whereas the study group yielded lower systolic pressure, diastolic pressure, and heart rate as compared with the control group (P＜0.05). (2) The study group interpreted shorter time to open eyes, time to regain consciousness, tracheal extubation time, and length of stay in the recovery room as compared with the control group (P＜0.05). (3) With the extension of observation time, the NRS score of the two groups gradually decreased, Ramsay sedation score gradually increased, and the NRS score and Ramsay sedation score at various time points in the study group were superior to those in the control group (P＜0.05). (4) The total incidence rate of adverse reactions of patients in the study group was lower than that in the control group (P＜0.05). ConclusionRemimazolam besylate combined with alfentanil exerts a favorable application effect in total intravenous anesthesia for daytime thyroidectomy. Compared with anesthetic regimen of propofol combined with alfentanil, the anesthetic regimen can preferably stabilize the intraoperative hemodynamics, and promote recovery of anesthesia of patients, exerting favorable analgesic and sedative effect, with a good medication safety.

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