Abstract: Objective To explore the effect of remimazolam on hemodynamics and postoperative stress of patients with general anesthesia for laparoscopic cholecystectomy （LC）. Methods A total of 68 patients who received LC treatment from January 2021 to January 2023 were selected as observation subjects. They were randomly divided into M group （n=34） and R group （n=34） using the envelope method. During anesthesia induction in the M group, midazolam, fentanyl, and cisatracurium besilate were used; during anesthesia induction in the R group, remimazolam, fentanyl, and cisatracurium besilate were used. The hemodynamic indicators, adverse reactions, and postoperative stress levels were compared between the M group and the R group at different time points. Results There were no statistically significant differences in heart rate （HR） and mean arterial pressure （MAP） between the two groups before induction （P>0.05）. At the time points before intubation, immediately after intubation, and 1 min after intubation, the HR and MAP in the R group were significantly lower than those in the M group （P<0.05）. At 24 h after operation, the levels of norepinephrine, cortisol, insulin, and C-peptide in the R group were significantly lower than those in the M group （P<0.05）. The incidence of dizziness and headache in the R group was significantly lower than that in the M group （P<0.05）. Conclusion When patients undergo LC treatment, using remimazolam for general anesthesia can effectively maintain the anesthesia effect, reduce their physiological stress level, and have high safety.

Key words: Laparoscopic cholecystectomy, General anesthesia, Remimazolam, Hemodynamics, Stress response, Safety