ORIGINAL RESEARCH article
Front. Med.
Sec. Intensive Care Medicine and Anesthesiology
Effects of Different Anesthetics on Remifentanil-Induced Postinfusion Hyperalgesia in Patients Undergoing Percutaneous Endoscopic Interlaminar Discectomy: A Randomized Controlled Trial
Provisionally accepted
- 1Qilu Hospital of Shandong University, Jinan, China
- 2Shandong University Cheeloo College of Medicine, Jinan, China
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Background: Continuous infusion of remifentanil during anesthesia potentially leads to remifentanil-induced postinfusion hyperalgesia (RPH), which may be regulated by anesthesia maintenance drugs. In this study, we investigated the effects of different anesthetics (remimazolam, propofol or sevoflurane) on RPH. Methods: One hundred and eleven patients who underwent percutaneous endoscopic interlaminar discectomy (PEID) under remifentanil-based anesthesia were randomized to 1 of 3 groups as follows: anesthesia maintenance with remimazolam (Group R), propofol (Group P) or sevoflurane (Group S). The mechanical pain thresholds of the forearm and incision area were measured using Von Frey filaments preoperatively and 24 h after surgery. Pain intensity, sufentanil consumption, side effects, and comfort and satisfaction were recorded for 24 h after surgery. Results: At 24 h after surgery, the mechanical pain thresholds around the skin incision were significantly greater in Group R (77.6 [19.7] vs. 63.7 [11.0] g, P<0.001) and Group P (73.9 [15.4] vs. 63.7 [11.0] g, P=0.019) than in Group S. Compared with Group S, Group R (3.9 [0.9] vs. 3.4 [0.7], P=0.005) and Group P (4.2 [0.5] vs. 3.4 [0.7], P=0.001) had significantly greater postoperative comfort and satisfaction at 24 h after surgery. The mechanical pain thresholds for the dominant inner forearm, postoperative pain intensity, sufentanil consumption, and side effects were similar among the three groups. Conclusions: Continuous infusion of Propofol or remimazolam attenuated RPH but not acute pain or analgesic consumption after PEID, potentially lowering the risk of chronic pain.
Keywords: Remimazolam, sevoflurane, Propofol, remifentanil-induced postinfusion hyperalgesia, Mechanical pain threshold
Received: 11 Aug 2025; Accepted: 03 Nov 2025.
Copyright: © 2025 Ba, Wang, Dai and Yang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shaozhong Yang, yszyang@163.com
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