Evaluation of intrathecal dexmedetomidine for spine surgery

Abstract

Background and aim Anesthesia for major lumbar spine surgeries is challenging to the anesthetist due to multiple perioperative problems and severe postoperative pain that require a tailored anesthetic technique. The aim of this study was to evaluate the effects of adding intrathecal dexmedetomidine to bupivacaine in combined spinal–general anesthesia with regard to the intraoperative hemodynamics and postoperative analgesia in patients subjected to elective major lumbar spine surgeries. Patients and methods In this prospective, randomized, double-blind study, 62 patients were assigned to one of two equal groups: bupivacaine group (B) and dexmedetomidine group (D). Time to the first rescue analgesic request was the primary outcome. Hemodynamics, blood loss, cumulative 24 h pethidine consumption, postoperative visual analog scale pain scores, and side effects were the secondary outcomes. Student’s t-test and Mann–Whitney U-test were used. P values less than 0.05 were considered significant. Results In group D, there was a longer time to the first postoperative opioid request (360.57±25.43 min vs. 162.00±9.33 min, P Conclusion Dexmedetomidine as an intrathecal adjuvant to bupivacaine during anesthesia for major lumbar spine surgeries provides better postoperative analgesic profile (increases the analgesic duration and decreases the amount of consumed opioids), and it causes more hypotension that is easily corrected and is in favor of reduced blood loss, compared with bupivacaine alone.