Observation of the efficacy and safety of remifentanil versus sufentanil during wake-up test in anesthesia for idiopathic scoliosis surgery
瑞芬太尼与舒芬太尼在特发性脊柱侧弯麻醉术中唤醒的效果和安全性观察

摘要

目的 观察瑞芬太尼与舒芬太尼在特发性脊柱侧弯矫形术术中唤醒环节的应用效果和安全性，为临床麻醉方案优化提供参考依据。方法 选取2025年11月至2026年2月我院收治的84例行后路特发性脊柱侧弯矫形内固定术患者作为研究对象，采用随机数字表法分为常规组和试验组，每组各42例。常规组术中维持输注舒芬太尼复合丙泊酚，试验组术中维持输注瑞芬太尼复合丙泊酚。比较两组患者的术中唤醒时间、唤醒质量、唤醒期间血流动力学波动幅度、不良反应发生率及术后镇痛效果5项核心观察指标。结果 试验组术中唤醒时间显著短于常规组，唤醒优良率高于常规组（P<0.05）；试验组唤醒期间平均动脉压（MAP）、心率（HR）波动幅度小于常规组（P<0.05）；试验组术中及术后24h内不良反应总发生率低于常规组（P<0.05）；试验组术后2h、6h、12h、24h视觉模拟评分法（VAS）评分均低于常规组（P<0.05）。结论 与舒芬太尼相比，瑞芬太尼应用于特发性脊柱侧弯矫形术术中唤醒，可缩短唤醒时间、提升唤醒质量，维持唤醒期间血流动力学稳定，降低不良反应发生率，且术后镇痛效果更优，安全性更高，更适合术中唤醒的麻醉管理需求。

Abstract

Objective To observe the effect and safety of remifentanil and sufentanil in the wake-up of idiopathic scoliosis surgery, and to provide a reference basis for the optimization of clinical anesthesia scheme.
Methods From November 2025 to February 2026, 84 patients who underwent posterior idiopathic scoliosis deformity correction and internal fixation surgery in our hospital were selected as the research objects. They were divided into the control group and the experimental group by randomized numerical table method, with 42 cases in each group. The control group was maintained with sufentanil combined with propofol during the operation, and the group was maintained with remifentanil combined with propofol during the operation. The five core observation indexes of the operation wake-up time, wake-up quality, fluctuation amplitude of hemodynamic during wake-up period, the incidence of adverse reactions and the postoperative analgesic effect were compared between the two groups.
Results The operation wakeup time in the experimental group was significantly shorter than that in the control group, and the rate of excellent wake-up was higher than that in the control group (P < .05). The average arterial pressure (MAP) and heart rate (HR) fluctuations in the experimental group were less than those in the control group during wake-up P < 0.05). The total incidence of adverse reactions in the experimental group was lower than that in the control group during the operation and within 24 hours the operation (P < 0.05). The visual analog score (VAS) scores at 2, 6, 12, and 24 after the operation in the experimental group were lower than those in the control group (P < 0.05).
Conclusion   Compared with Sufentanil can shorten the wake-up time, improve the quality of wake-up, maintain the stability of hemodynamics during wake-up, reduce the incidence of reactions, and provide better postoperative analgesic effect and higher safety for the anesthetic management needs of wake-up during surgery.