Sodium oxybate with reduced-dose propofol for anesthesia induction in elective spine surgery: a randomized trial.
- 1Department of Anesthesiology, Tsinghua University Yuquan Hospital (Tsinghua University Hospital of Integrated Traditional Chinese and Western Medicine), Beijing, China.
- 2Department of Anesthesiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Abstract
Background
Sodium oxybate has an established sedative action, but its contribution to contemporary propofol-based anesthesia remains incompletely characterized. We evaluated induction hemodynamics, propofol use, bispectral index (BIS), and early recovery in elective spine surgery.Methods
In this single-center randomized trial, 127 patients received propofol alone (P; n = 62) or propofol plus sodium oxybate (PS; n = 65). Planned induction doses were propofol 2.2 versus 1.2 mg/kg, with oxybate 30 mg/kg in PS; recorded propofol doses were lower in both groups. The primary outcome was the mean arterial pressure (MAP) trajectory across 13 induction landmarks. Maximum-likelihood mixed models were supplemented by unstructured-covariance and baseline-adjusted analyses.Results
The primary group-by-time interaction was not significant (P = 0.607; unstructured covariance, P = 0.719). The baseline-adjusted average post-baseline MAP difference was 1.7 mmHg (PS minus P; 95% confidence interval [CI], -2.0-5.5). Systolic-pressure-defined hypotension occurred in 37/62 versus 32/65 patients (risk ratio, 0.82; 95% CI, 0.60-1.14; risk difference, -10.4 percentage points; 95% CI, -26.8-6.7). Recorded total propofol use was 31.4% lower (751.3 versus 515.4 mg; difference, -235.9 mg; 95% CI, -366.0 to -105.9). Maintenance use was also lower under unblinded BIS-guided titration. Post-intubation BIS <40 occurred in 2/62 versus 22/65 patients. The mean surgery-end-to-extubation interval was 10.5 versus 13.6 min (difference, 3.1 min; 95% CI, 0.9-5.2), although both medians were 10 min. Vasoactive-treatment documentation was incomplete.Conclusions
The oxybate-containing strategy was associated with substantially lower propofol use, lower BIS values, and a longer mean extubation interval; hemodynamic superiority was not demonstrated. These findings define the observed effects and trade-offs of the combined regimen under BIS-guided care and inform further evaluation of dose selection, hypnosis monitoring, and recovery.Clinical trial registration
https://www.chictr.org.cn Chinese Clinical Trial Registry, ChiCTR2400080686.
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BibTeX
@article{yu2026sodium,
title = {{Sodium oxybate with reduced-dose propofol for anesthesia induction in elective spine surgery: a randomized trial.}},
author = {Jianfeng Yu and Cuiping Yu and Nanling Wu and Kaixuan Zhao and Yimeng Xia and Ting Fan},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1970835},
url = {https://europepmc.org/article/MED/42948135},
note = {CC BY},
}
RIS
TY - JOUR
TI - Sodium oxybate with reduced-dose propofol for anesthesia induction in elective spine surgery: a randomized trial.
AU - Jianfeng Yu
AU - Cuiping Yu
AU - Nanling Wu
AU - Kaixuan Zhao
AU - Yimeng Xia
AU - Ting Fan
PY - 2026
DA - 2026/10/13
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1970835
UR - https://europepmc.org/article/MED/42948135
AB - Background Sodium oxybate has an established sedative action, but its contribution to contemporary propofol-based anesthesia remains incompletely characterized. We evaluated induction hemodynamics, propofol use, bispectral index (BIS), and early recovery in elective spine surgery.Methods In this single-center randomized trial, 127 patients received propofol alone (P; n = 62) or propofol plus sodium oxybate (PS; n = 65). Planned induction doses were propofol 2.2 versus 1.2 mg/kg, with oxybate 30 mg/kg in PS; recorded propofol doses were lower in both groups. The primary outcome was the mean arterial pressure (MAP) trajectory across 13 induction landmarks. Maximum-likelihood mixed models were supplemented by unstructured-covariance and baseline-adjusted analyses.Results The primary group-by-time interaction was not significant (P = 0.607; unstructured covariance, P = 0.719). The baseline-adjusted average post-baseline MAP difference was 1.7 mmHg (PS minus P; 95% confidence interval [CI], -2.0-5.5). Systolic-pressure-defined hypotension occurred in 37/62 versus 32/65 patients (risk ratio, 0.82; 95% CI, 0.60-1.14; risk difference, -10.4 percentage points; 95% CI, -26.8-6.7). Recorded total propofol use was 31.4% lower (751.3 versus 515.4 mg; difference, -235.9 mg; 95% CI, -366.0 to -105.9). Maintenance use was also lower under unblinded BIS-guided titration. Post-intubation BIS <40 occurred in 2/62 versus 22/65 patients. The mean surgery-end-to-extubation interval was 10.5 versus 13.6 min (difference, 3.1 min; 95% CI, 0.9-5.2), although both medians were 10 min. Vasoactive-treatment documentation was incomplete.Conclusions The oxybate-containing strategy was associated with substantially lower propofol use, lower BIS values, and a longer mean extubation interval; hemodynamic superiority was not demonstrated. These findings define the observed effects and trade-offs of the combined regimen under BIS-guided care and inform further evaluation of dose selection, hypnosis monitoring, and recovery.Clinical trial registration https://www.chictr.org.cn Chinese Clinical Trial Registry, ChiCTR2400080686.
SN - 2296-858X
ER -