ObjectiveTo explore the effects and safety of remimazolam in combination with remifentanil for anesthesia during hysteroscopic surgery.MethodsA total of 120 patients who underwent hysteroscopic surgery at our hospital from June 2022 to June 2024 were included, and were randomly divided into the control group (n=60) and the study group(n=60). The control group received remifentanil plus propofol for anesthesia, while the study group received remifentanil plus remimazolam. The hemodynamic parameters, anesthesia induction time, emergence time, orienting recovery time, satisfaction score, and adverse reactions of the two groups were compared.ResultsThere were no differences in mean arterial pressure (MAP), heart rate(HR), and oxygen saturation(SpO₂) between the two groups before anesthesia induction (T0) and at the end of surgery (T3)(P>0.05). The MAP and SpO₂ values at 1 minute after induction (T1) and during cervical dilation (T2) were lower than T0 in both groups, with the study group being higher than those of the control group (P<0.05). The HR value at T1 and T2 were higher than T0 in both groups, with the study group being lower than the control group (P<0.05). The anesthesia induction time, emergence time and orienting recovery time were shorter than those in the control group (P<0.05). The satisfaction score in the study group was higher than that in the control group[(4.82±0.46) points vs. (4.13±0.37) points, P<0.05]. The incidence of adverse reactions in the study group was lower than that in the control group (8.33% vs. 21.67%, P<0.05).ConclusionThe combination of remimazolam and fentanyl provides good anesthesia effects, which can effectively maintain hemodynamic stability of patients undergoing hysteroscopic surgery, and reduce emergence time and the incidence of adverse reactions.