Study Summary

Eighty patients with vertebral compression fractures undergoing elective single-level percutaneous vertebroplasty (PVP) under monitored anesthesia care (MAC) were randomized to receive propofol TCI with remifentanil at either 1.0 ng/mL (Group 1, n = 40) or 2.0 ng/mL (Group 2, n = 40). The primary outcome was disruptive intraoperative patient movement. Secondary outcomes included hemodynamic stability, anesthetic use and titration, cardiopulmonary events, postoperative pain and recovery, and patient and surgeon satisfaction within 24 hours. Overall, the higher remifentanil concentration markedly reduced disruptive movement, improved blood pressure and heart rate stability, required fewer dose escalations, and increased surgeon satisfaction, without added cardiopulmonary risk. These findings suggest that initiating remifentanil at 2.0 ng/mL optimizes operative conditions and hemodynamics while preserving safety and recovery.