Effect of dexmedetomidine on intraoperative blood loss during orthopedic surgery for adolescent idiopathic scoliosis

Abstract

American Society of Anesthesiologists(ASA)physical statusⅠor Ⅱ patients, aged 11-18 yr, scheduled for elective posterior orthopedic surgery for adolescent idiopathic scoliosis from November 2011 to October 2015 in our hospital, were selected, and a total of 834 patients were included in the study.Data including age, gender, body height, body weight, Cobb angles, ASA physical status, osteotomy procedure, use of dexmedetomidine, the number of operation segments, duration of operation, intraoperative blood loss, volume of blood transfused and volume of fluid infused, volume of postoperative drainage and length of postoperative hospital stay were recorded.The patients were divided into dexmedetomidine group(group D, n=508)and non-dexmedetomidine group(group ND, n=326)depending on whether or not dexmedetomidine was used.Age, gender, body mass index, Cobb angles, ASA physical status, the number of operation segments, duration of operation, osteotomy procedure and use of dexmedetomidine were served as independent variables and analyzed using Stepwise multivariate linear regression.The results of Stepwise multivariate linear regression showed that osteotomy procedures, the number of operation segments, duration of operation and Cobb angles were positively correlated with intraoperative blood loss, and use of dexmedetomidine and body mass index were negatively correlated with intraoperative blood loss.Compared with group ND, the intraoperative blood loss, volume of crystalloid solution infused, volume of blood transfused and volume of postoperative drainage were significantly reduced in group D(P<0.05). After a propensity score matching analysis, the intraoperative blood loss and volume of crystalloid solution infused were significantly reduced in group ND when compared with group D(P<0.05). In conclusion, intraoperative use of dexmedetomidine is helpful in reducing intraoperative blood loss during orthopedic surgery for adolescent idiopathic scoliosis. Key words: Dexmedetomidine; Scoliosis; Orthopedic procedure; Blood loss, surgical