Remimazolam combined with propofol for intraoperative wake-up testing in scoliosis correction surgery: a prospective, blind, randomized controlled trial Article Swipe
Jing Luo
,
Da Lin Chen
,
Zong-Long Lv
,
Hui Zhong
,
Yong-Hui Zhao
,
Yu-Jin Li
,
Xin Nan Li
,
Jing-Ce Chen
,
Wen Bao Shi
,
Yun Bo
,
Rong-Qian Lin
,
You Zhi Yang
,
Sheng Lu
,
Wen Sen Li
,
Hua Jin
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3389/fphar.2025.1685683
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.3389/fphar.2025.1685683
Purpose Remimazolam is a fast-acting benzodiazepine used for anesthesia and sedation, notable for its quick onset and reversible effects. Its role in wake-up testing during spinal deformity surgery is uncertain. This study assessed the effectiveness and safety of combining remimazolam with propofol during wake-up tests in scoliosis correction surgery. Methods In this randomized trial, 54 scoliosis surgery patients were assigned to receive either propofol alone (Group P), propofol with dexmedetomidine (Group D), or propofol with remimazolam (Group R). Primary outcomes were wake-up time and quality; secondary outcomes included spinal monitoring, cerebral indices, hemodynamic stability, surgery duration, Visual Analog Scale and Behavioral Comfort Scale scores, satisfaction, and postoperative adverse events. Results Mean wake-up times varied significantly across groups: 10.58 ± 1.60 min (Group P), 16.14 ± 2.64 min (Group D), and 6.69 ± 3.85 min (Group R) ( p = 0.001). Post-hoc analysis revealed Group R had significantly shorter wake-up times than Group P (mean difference, 3.9 min; p = 0.0005) and Group D (mean difference, 9.4 min; p = 0.0001). Excellent wake-up quality was reported in 50% of Group P, 100% of Group D, and 94.4% of Group R ( p = 0.0002). Group R also had a shorter mean operative duration (256.3 ± 74.4 min) compared to Group P (264.4 ± 60.4 min) and Group D (310.9 ± 57.9 min) ( p = 0.03). Additionally, Group R showed significantly higher amnesia indices at multiple time points compared to Groups P and D ( p < 0.05). Hemodynamic assessments revealed that Group D had significantly lower heart rates at T2, T3, and T4 than Groups P and R ( p < 0.05). Group R also had a higher mean arterial pressure than Group P at T2 ( p < 0.05). Surgeon satisfaction scores were significantly higher in Group R than in Groups P and D ( p = 0.0001), and patient satisfaction scores in Group R were higher than in Group P ( p = 0.0001). No significant differences were observed in other secondary outcomes ( p > 0.05). Conclusion The remimazolam-propofol combo for intraoperative wake-up testing in scoliosis correction surgery shows superior efficacy with quicker wake-up times, better wakefulness quality, and higher satisfaction, without affecting spinal neurophysiological monitoring. This suggests it as a promising sedative option for spinal deformity surgeries. Clinical Trial Registration https://www.chictr.org.cn/bin/project/edit?pid=203900 as ChiCTR2300076802.
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Metadata
- Type
- article
- Landing Page
- https://doi.org/10.3389/fphar.2025.1685683
- https://public-pages-files-2025.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1685683/pdf
- OA Status
- gold
- References
- 40
- OpenAlex ID
- https://openalex.org/W7106510019
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
-
https://openalex.org/W7106510019Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.3389/fphar.2025.1685683Digital Object Identifier
- Title
-
Remimazolam combined with propofol for intraoperative wake-up testing in scoliosis correction surgery: a prospective, blind, randomized controlled trialWork title
- Type
-
articleOpenAlex work type
- Publication year
-
2025Year of publication
- Publication date
-
2025-11-24Full publication date if available
- Authors
-
Jing Luo, Da Lin Chen, Zong-Long Lv, Hui Zhong, Yong-Hui Zhao, Yu-Jin Li, Xin Nan Li, Jing-Ce Chen, Wen Bao Shi, Yun Bo, Rong-Qian Lin, You Zhi Yang, Sheng Lu, Wen Sen Li, Hua JinList of authors in order
- Landing page
-
https://doi.org/10.3389/fphar.2025.1685683Publisher landing page
- PDF URL
-
https://public-pages-files-2025.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1685683/pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
-
https://public-pages-files-2025.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2025.1685683/pdfDirect OA link when available
- Concepts
-
Propofol, Medicine, Anesthesia, Randomized controlled trial, Hemodynamics, Scoliosis, Benzodiazepine, Sedation, Spinal deformity, Surgery, Dexmedetomidine, Adverse effect, Spinal anesthesia, Visual analogue scale, Idiopathic scoliosis, Bispectral index, Midazolam, Anesthetic, Amnesia, Elective surgery, Clinical trialTop concepts (fields/topics) attached by OpenAlex
- Cited by
-
0Total citation count in OpenAlex
- References (count)
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40Number of works referenced by this work
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