Objective: To observe the clinical effect of remifentanil combined with rimazolen benzenesulfonate for total intravenous anesthesia in laparoscopic cholecystectomy(LC). Methods: Sixty patients who underwent LC in our hospital from June 2023 to February 2024 were enrolled, including 26 males and 34 females, aged 23-73 years, with body mass index(BMI) 20.2-26.5 kg·m^-2, and the American Society of anesthesiologists(ASA) grade Ⅰ or Ⅱ. They were randomly assigned to remifentanil besylate group(group R, n=30) or propofol group(group B, n=30). Group B received intravenous infusion of 1% propofol at a rate of 200 mL·h^-1, while group R received intravenous infusion of 0.15% remifentanil besylate at a rate of 200 mL·h^-1 for anesthesia induction. After successful tracheal intubation, both groups of patients were administered remifentanil at a rate of 6-8 μg·(kg·h)^-1. Group B received intravenous infusion of propofol at a rate of 3-4 mg·(kg·h)^-1, while group R received continuous infusion of remifentanil besylate at a rate of 1 mg·(kg·h)^-1, maintaining a bispectral index(BIS) value between 40 and 60. Rocuronium bromide was added at a rate of 0.2 mg·kg^-1 according to the surgical duration. The BIS, heart rate(HR), and mean arterial pressure(MAP) data of two groups were recorded before induction(T0), immediately after induction(T1), immediately after endotracheal intubation(T2), before surgery(T3), 30 min after surgery(T4), and at the end of surgery(T5). The postoperative time of tracheal tube removal, the observer's assessment of alertness/sedation scale(OAA/S) at 15 min after tracheal tube removal, the duration of stay in the post anesthesia care unit(PACU) of the two groups were observed and recorded, and the adverse reactions such as nausea, vomiting, and intraoperative awareness were recorded. The patients were followed up for 3 d after surgery to observe the occurrence of postoperative delirium. Results: Both groups rapidly achieved the preset BIS value during induction, and the BIS value remained stable during anesthesia. Although the decrease in BIS value was more significant in group B than in group R, there was no significant difference in induction time between the two groups(t=1.124, P>0.05). During the operation, the number of patients who used the cardiovascular active drug epinephrine was significantly higher in group B than in group R(χ²=7.612, P<0.05). The postoperative extubation time of group B patients was shorter than that of group R(t=5.22, P<0.05). However, there were no significant differences in the duration of stay in the recovery room or OAA/S sedation score after extubation. No patients in either group experienced intraoperative awareness, and no significant postoperative adverse reactions were observed. Conclusion: Compared with propofol, remifentanil besylate provides safe and effective induction and maintenance of anesthesia for LC, with rapid and complete effects and less impact on the cardiovascular system.