Abstract:Objective To explore the clinical effects and postoperative cognitive function outcomes of different combination dosages of remimazolam and etomidate in brain tumor resection. Methods A total of 104 patients who underwent brain tumor resection in the Brain Hospital Affiliated to Nanjing Medical University from January 2024 to January 2025 were selected as the research objects. According to the anesthesia regimen, the patients were divided into a control group (n=52, receiving remimazolam 0.3 mg/kg + etomidate 0.1 mg/kg for anesthesia maintenance) and an observation group (n=52, receiving remimazolam 0.2 mg/kg + etomidate 0.15 mg/kg for anesthesia maintenance). The anesthetic effects of the two groups were compared. Results The heart rate (HR) and mean arterial pressure (MAP) of the observation group were lower than those of the control group at each time point: 5 minutes after intubation, at skin incision, during trephination, at dura incision, and at completion of surgery (P<0.05). The time of anesthesia onset, extubation, recovery, and stay in the anesthetic room in the observation group were shorter than those in the control group (P<0.05). At 24 hours after surgery, the Mini Mental State Examination (MMSE) score of the observation group was higher than that of the control group (P<0.05), and the Visual Analog Scale (VAS) score at each time point was lower than that of the control group (P<0.05). There was no significant difference in adverse reactions between two groups (χ²=0.377, P=0.539). Conclusion In brain tumor resection, the use of remimazolam 0.2 mg/kg combined with etomidate 0.15 mg/kg for anesthesia maintenance is effective. It not only optimizes the anesthesia management strategy and improves the safety and effectiveness of the operation, but also reduces hemodynamic fluctuations, relieves patient pain, abd accelerates the anesthesia recovery process.