Effects of remimazolam versus propofol on cerebral oxygenation in elderly patients undergoing prone spine surgery: study protocol for a randomised controlled trial

Prone spine surgery may increase the risk of cerebral hypoperfusion and postoperative neurological adverse events, particularly in elderly patients. Remimazolam is a novel ultra-short-acting benzodiazepine anaesthetic that may provide greater haemodynamic stability than propofol. However, its effects on cerebral oxygenation during prone spine surgery remain unclear, indicating clinical equipoise between remimazolam and propofol. This study compares the effects of remimazolam and propofol on cerebral oxygenation in elderly patients undergoing thoracic or lumbar spine surgery in the prone position under general anaesthesia.