Abstract: Objective To investigate the effects of perioperative oxycodone concentration on depth of anesthesia and postoperative recovery quality in patients undergoing lumbar spine surgery. Methods A total of 120 patients who underwent lumbar spine surgery at the Affiliated Traditional Chinese Medicine Hospital of Jiaxing University from November 2023 to April 2025 were enrolled. They were randomly divided into three groups using a random number table method, with 40 cases in each. All groups received identical induction of anesthesia and operative maintenance, except for the oxycodone dose. The oxycodone doses were 0.05 mg·kg^-1 in group A, 0.08 mg·kg^-1 in group B, and 0.12 mg · kg^-1 in group C. Perioperative parameters were compared. Mean arterial pressure (MAP), heart rate (HR), and bispectral index (BIS) were recorded at the following time points: before induction of anesthesia (T0), during tracheal intubation (T1), 30 minutes after surgical incision (T2), and at the end of the operation (T3). Postoperative Visual Analogue Scale (VAS) at 4, 8, 12 and 24 hours, and the incidence of adverse reactions were also compared among the groups. Results Compared with group B and C, group A had a shorter recovery time but required a higher intraoperative dosage of sufentanil. Group B had a shorter recovery time in than group C, but used more intraoperative sufentanil than group C (P ＜ 0.05). At T1, MAP and HR in group A were higher than those in group B and C, and these parameters in group B were higher than those in group C (P ＜ 0.05). The BIS at T1 was higher in Group A than that in group B and C (P ＜ 0.05), while no statistically significant difference was found between group B and C (P ＞ 0.05). The VAS score at 4 hours postoperatively was higher in group A than in group B and C, and higher in group B than group C (P ＜ 0.05). The total incidence of adverse reactions in group B was lower than that in group A and C (P ＜ 0.05). Conclusion Compared to doses of 0.05 mg · kg^-1 and 0.12 mg · kg^-1, oxycodone at a dose of 0.08 mg · kg^-1 is more effective in stabilizing the depth of anesthesia during lumbar spine surgery. This dosage has minimal impact on postoperative recovery time, provides satisfactory analgesic, ensures quality of recovery, and demonstrates a favorable safety profile, making it worthy of clinical promotion.