American journal of translational research · 2026
Effect of intravenous infusion of remimazolam versus propofol on intraoperative neurophysiological monitoring stability and postoperative neurological function in patients undergoing spinal surgery.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Cui Jing, Zhou Baolong, Wang Junjie, Yao Lan
Аннотация
OBJECTIVES: Intraoperative neurophysiological monitoring (IONM) plays a critical role in spinal surgery by reducing the risk of nerve injury; however, its quality can be significantly influenced by anesthetic agents. This study aimed to compare the effects of remimazolam and propofol on IONM performance and postoperative recovery.
METHODS: This retrospective analysis included patients who underwent prone-position spinal surgery with IONM between January 2021 and June 2025. Patients were divided into either a remimazolam group or a propofol group according to the primary sedative administered. The outcomes assessed included IONM parameters [somatosensory evoked potentials (SEP)/motor evoked potentials (MEP) amplitude/latency] after intubation (T1) and at 30 min (T3) and 50 min (T4) following recovery from neuromuscular blockade. Additional outcomes included hemodynamics, remifentanil consumption, recovery time, and cognitive function scores.
RESULTS: A total of 204 patients included in the analysis (Remimazolam group: 101 cases, Propofol group: 103 cases). Compared to the propofol group, the remimazolam group demonstrated significantly improved IONM signals, higher SEP amplitude at T4 (2.16 vs. 1.97 μV, P<0.001), and higher MEP amplitude at T4 (1680.73 vs. 1500.64 μV, P<0.001). The incidence of hypotension (6.93% vs. 19.42%, P=0.009) and bradycardia (5.94% vs. 14.56%, P=0.043) were significantly lower, while remifentanil consumption was significantly higher (2005.64 vs. 1425.44 ug, P<0.001) in the remimazolam group. In addition, patients in the remimazolam group exhibited shorter recovery times (awakening time: 18.91 vs. 24.25 min, P<0.001) and better cognitive function (MoCA score on postoperative Day 3: 24.41 vs. 23.54, P<0.001).
CONCLUSIONS: Remimazolam provides superior IONM conditions, a lower incidence of intraoperative hypotension and bradycardia, and faster postoperative recovery compared to propofol in patients undergoing spinal surgery.
METHODS: This retrospective analysis included patients who underwent prone-position spinal surgery with IONM between January 2021 and June 2025. Patients were divided into either a remimazolam group or a propofol group according to the primary sedative administered. The outcomes assessed included IONM parameters [somatosensory evoked potentials (SEP)/motor evoked potentials (MEP) amplitude/latency] after intubation (T1) and at 30 min (T3) and 50 min (T4) following recovery from neuromuscular blockade. Additional outcomes included hemodynamics, remifentanil consumption, recovery time, and cognitive function scores.
RESULTS: A total of 204 patients included in the analysis (Remimazolam group: 101 cases, Propofol group: 103 cases). Compared to the propofol group, the remimazolam group demonstrated significantly improved IONM signals, higher SEP amplitude at T4 (2.16 vs. 1.97 μV, P<0.001), and higher MEP amplitude at T4 (1680.73 vs. 1500.64 μV, P<0.001). The incidence of hypotension (6.93% vs. 19.42%, P=0.009) and bradycardia (5.94% vs. 14.56%, P=0.043) were significantly lower, while remifentanil consumption was significantly higher (2005.64 vs. 1425.44 ug, P<0.001) in the remimazolam group. In addition, patients in the remimazolam group exhibited shorter recovery times (awakening time: 18.91 vs. 24.25 min, P<0.001) and better cognitive function (MoCA score on postoperative Day 3: 24.41 vs. 23.54, P<0.001).
CONCLUSIONS: Remimazolam provides superior IONM conditions, a lower incidence of intraoperative hypotension and bradycardia, and faster postoperative recovery compared to propofol in patients undergoing spinal surgery.