Objective:To compare the hemodynamic effects of propofol and remimazolam during the perioperative period in Stanford type B aortic dissection patients. Methods:eighty patients were randomized to receive propofol (Group P) or remimazolam (Group R) for anesthesia. Mean arterial pressure (MAP) and bispectral index (BIS) value were recorded at anesthesia onset (T0), tracheal intubation (T1), 5 minutes after intubation (T2), procedure completion (T3), airway extubation (T4), and 5 minutes after airway extubation (T5). The percentage change in MAP during anesthesia induction was computed as (MAPT2 -MAPT0) / MAPT0, and during the periextubation period, it was calculated as (MAPT5 - MAPT3) /MAPT3. Results:No significant differences in BIS values were observed between the two groups at any time point (P < 0.05). The percentage change in MAP during anesthesia induction was 22.6%±6.5% in Group P and 13.7%±6.9% in Group R, showing a significant difference (P < 0.001). Similarly, during the periextubation period, the mean percentage change in MAP was 21.3%±6.2% in Group P and 11.7%±5.8% in Group R, also indicating a significant difference (P< 0.001). Conclusion：These findings indicate that remimazolam exerted a milder cardiovascular depression effect compared to propofol when delivering same sedation, which has certain positive significance for reducing perioperative complications in these patients.