Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial
Background Although total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used to optimize intraoperative neurophysiological monitoring (IONM), the exact effect of remimazolam on IONM remains unknown. Here, we compared the effects of propofol and remimazolam along with rem...
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Korean Society of Anesthesiologists
2025-02-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kja-24613.pdf |
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| author | Myoung Hwa Kim Jinyoung Park Yoon Ghil Park Yong Eun Cho Dawoon Kim Dong Jun Lee Kyu Wan Kwak Jongyun Lee Dong Woo Han |
| author_facet | Myoung Hwa Kim Jinyoung Park Yoon Ghil Park Yong Eun Cho Dawoon Kim Dong Jun Lee Kyu Wan Kwak Jongyun Lee Dong Woo Han |
| author_sort | Myoung Hwa Kim |
| collection | DOAJ |
| description | Background Although total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used to optimize intraoperative neurophysiological monitoring (IONM), the exact effect of remimazolam on IONM remains unknown. Here, we compared the effects of propofol and remimazolam along with remifentanil on IONM during TIVA. Methods In this prospective, double-blind, randomized controlled trial, 64 patients requiring IONM during cervical spine surgery were administered either propofol (Group P) or remimazolam (Group R). The preoperative latencies of the somatosensory-evoked potentials (SEP; N20 for the median nerve and P37 for the tibial nerve) were measured. SEP latencies and amplitudes and motor-evoked potential (MEP) amplitudes were measured 30 min after anesthetic induction (T1), 30 min after surgical incision (T2), after laminectomy or discectomy (T3), immediately after plate insertion or pedicle screw fixation (T4), and before surgical wound closure (T5). The primary outcome was the between-group difference in the N20 latency changes measured at T1 and preoperatively. Results The change in SEP latencies including N20 and P37 at T1 compared with preoperative time was not significantly different between Groups P and R. Except for the amplitude of the right abductor brevis, there was no significant group-by-time interaction effect for intraoperative MEP amplitudes or SEP latencies and amplitudes. Conclusions TIVA with remimazolam and remifentanil for cervical spine surgery yielded stable IONM, comparable to those observed with conventional TIVA with propofol and remifentanil. Further clinical trials are needed in other surgical contexts and with more diverse patient populations to determine the effects of remimazolam on IONM. |
| format | Article |
| id | doaj-art-4aa5d602aa0641e9ab8459e9c50d001f |
| institution | Kabale University |
| issn | 2005-6419 2005-7563 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj-art-4aa5d602aa0641e9ab8459e9c50d001f2025-02-03T08:32:46ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632025-02-01781162910.4097/kja.246139021Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trialMyoung Hwa Kim0Jinyoung Park1Yoon Ghil Park2Yong Eun Cho3Dawoon Kim4Dong Jun Lee5Kyu Wan Kwak6Jongyun Lee7Dong Woo Han8 Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Neurosurgery, Spine and Spinal Cord Institute, Gangnam Severance Spine Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, KoreaBackground Although total intravenous anesthesia (TIVA) with propofol and remifentanil is frequently used to optimize intraoperative neurophysiological monitoring (IONM), the exact effect of remimazolam on IONM remains unknown. Here, we compared the effects of propofol and remimazolam along with remifentanil on IONM during TIVA. Methods In this prospective, double-blind, randomized controlled trial, 64 patients requiring IONM during cervical spine surgery were administered either propofol (Group P) or remimazolam (Group R). The preoperative latencies of the somatosensory-evoked potentials (SEP; N20 for the median nerve and P37 for the tibial nerve) were measured. SEP latencies and amplitudes and motor-evoked potential (MEP) amplitudes were measured 30 min after anesthetic induction (T1), 30 min after surgical incision (T2), after laminectomy or discectomy (T3), immediately after plate insertion or pedicle screw fixation (T4), and before surgical wound closure (T5). The primary outcome was the between-group difference in the N20 latency changes measured at T1 and preoperatively. Results The change in SEP latencies including N20 and P37 at T1 compared with preoperative time was not significantly different between Groups P and R. Except for the amplitude of the right abductor brevis, there was no significant group-by-time interaction effect for intraoperative MEP amplitudes or SEP latencies and amplitudes. Conclusions TIVA with remimazolam and remifentanil for cervical spine surgery yielded stable IONM, comparable to those observed with conventional TIVA with propofol and remifentanil. Further clinical trials are needed in other surgical contexts and with more diverse patient populations to determine the effects of remimazolam on IONM.http://ekja.org/upload/pdf/kja-24613.pdfanesthesia, intravenousevoked potentials, motorevoked potentials, somatosensoryintraoperative neurophysiological monitoringpropofolremimazolam |
| spellingShingle | Myoung Hwa Kim Jinyoung Park Yoon Ghil Park Yong Eun Cho Dawoon Kim Dong Jun Lee Kyu Wan Kwak Jongyun Lee Dong Woo Han Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial Korean Journal of Anesthesiology anesthesia, intravenous evoked potentials, motor evoked potentials, somatosensory intraoperative neurophysiological monitoring propofol remimazolam |
| title | Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial |
| title_full | Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial |
| title_fullStr | Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial |
| title_full_unstemmed | Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial |
| title_short | Comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery: a prospective, double-blind, randomized controlled trial |
| title_sort | comparison of intraoperative neurophysiological monitoring between propofol and remimazolam during total intravenous anesthesia in the cervical spine surgery a prospective double blind randomized controlled trial |
| topic | anesthesia, intravenous evoked potentials, motor evoked potentials, somatosensory intraoperative neurophysiological monitoring propofol remimazolam |
| url | http://ekja.org/upload/pdf/kja-24613.pdf |
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