Abstract: AIM: To compare the effects of remifentanil and fentanyl for posterior scoliosis correction and the influences on postoperative pain.METHODS: Forty patients scheduled for posterior scoliosis correction (ASA Ⅰ-Ⅱ, aged 11-18 years) were randomly divided into group remifentanil (group R) and group fentanyl (group F).Anesthesia was maintained with propofol, vecuronium bromide and sevoflurane. Intravenous remifentanil (0.2μg°kg^-1°min^-1) and fentanyl (1μg°kg^-1°h^-1) were continuously administered for analgesia.Vecuronium bromide and analgesics were discontinued around 30 min before the wake-up test.The wake up time from propofol and sevoflurane discontinuation to movement of the patient's toe were recorded.In group R, once remifentanil infusion was stopped before surgery ended, the patients were injected with fentanyl 2μg kg.All of the patients received intravenous fentanyl (10μg°kg^-1°min^-1) for postoperative analgesia and were interviewed for pain degree during the first 24 h after surgery.RESULTS: The wake-up time were (12.3 ±5.7) min in group R and (21.6 ±6.5) min in group F(P <0.01).The analgesia efficacies in two groups were satisfactory.There was no significant difference in VAS (visual analog scale) score between the two groups during the first 24 h after surgery.CONCLUSION: Compared with group F, the wake-up time was shorted obviously in group R in posterior scoliosis correction.Remifentanil (0.2μg°kg^-1°min^-1) did not trigger postoperative hyperalgesia when fentanyl was applied after discontinuation of remifentanil during the surgery.

Key words: wake-up test, sevoflurane, remifentanil, spinal surgery