Intraoperative wake-up test in patients undergoing spinal surgery:A comparison of intravenous anesthesia and combined intravenous and inhalation anesthesia

Objective: Study the effects of intravenous anesthesia and combined intravenous and inhalation anesthesia on arousing time and recovery quality in spinal surgery.Methods: 55 patients（ASA I-II） were divided randomly into 3 groups: group PR（propofol-remifentanil）: target-controlled infusion with propofol（plasma concentration,2-4 μg·mL^-1） and remifentanil 0.2-0.4 μg·kg^-1·min^-1;group DR（desflurane-remifentanil）: desflurane/air 3.0-4.0 Vol% combined with remifentanil 0.2-0.4 μg·kg^-1·min^-1;and group PFN（propofol-fentanyl-N₂O）: target-controlled infusion with propofol（plasma concentration,2-4 μg·mL^-1）,N₂O（N₂O∶O₂= 1∶1）,and repetitive boluses of 1-2 μg·kg-1 of fentanyl adjusted to patients requirements.Results: Group PFN required significantly longer times for the onset of breathing（8.9±1.6）min,and motion of the feet （12.3±5.6）min than group PR（6.7±2.1）min,and（9.8±2.4）min,respectively or group DR （5.8±0.6）min,and（6.4±0.9）min,respectively.Conclusion: The anesthetic regimen with desflurane and remifentanil allowed faster awakening during surgery that permitted immediate neurological examination compared with propofol-remifentanil and propofol-fentanyl-N2O.