75 elderly patients scheduled to undergo vertebroplasty or kyphoplasty for compression fracture were randomized to receive either remifentanil or dexmedetomidine as a sedative during monitored anaesthesia care. The purpose of this study was to compare the effects of the two treatments on patients' haemodynamic stability and respiratory condition. Findings indicated significantly lower mean arterial pressure (MAP) and heart rate (HR), and higher SpO2 levels in the dexmedetomidine group compared to the remifentanil group. Remifentanil was also associated with significantly higher production of respiratory depression and oxygen desaturation, but reduced the need for additional opioids. Recovery time, investigators' satisfaction scores and patients' overall pain outcomes were comparable between groups.