Evaluation of the effects of intrathecal bupivacaine-dexmedetomidine for lumbar spine fusion: a double blinded randomized controlled study

R.A. Salem, E.I. Darweesh, M.A. Wanis, A.A. Mohamed

Departments of Anesthesiology and 2Departments of Orthopedics, Sohag Faculty of Medicine, Sohag University, Sohag, Egypt. raafatsalem72@yahoo.com

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• Anesthesiology

OBJECTIVE: To evaluate the efficacy of intrathecal dexmedetomidine at improving the quality of the operative field, and prolonging the duration of sensory block, motor block, and postoperative analgesia during spinal surgery

PATIENTS AND METHODS: This prospective, double-blinded, randomized controlled study included 52 patients undergoing an instrumented one-level posterolateral lumbar spine fusion for lumbar spondylolisthesis under spinal anesthesia. The patients were randomized into two groups: group D (n = 26) received 15 mg of hyperbaric bupivacaine with 5 μg of dexmedetomidine, while group P (n = 26) received 15 mg of hyperbaric bupivacaine only. The operative field quality score, blood loss volume, and the surgeon’s satisfaction with the procedure were recorded. The onset time of the sensory block, time to reach peak sensory level, sensory and motor regression times, time to the first requirement of analgesia, sedation level, hemodynamics, and all postoperative complications were also recorded.

RESULTS: The operative field quality and the surgeon’s satisfaction scores (rated excellent) were significantly better in group D than in group P (p < 0.0001 and p = 0.003, respectively). Patients in group D had significantly longer sensory and motor regression times than patients in group P (p < 0.0001). The time to the first requirement of analgesia and the total dose of ketorolac was significantly longer and smaller, respectively, in group D than in group P (p < 0.0001).

CONCLUSIONS: Intrathecal bupivacaine-dexmedetomidine improved the quality of the operative field, prolonged the duration of the sensory and motor block, prolonged postoperative analgesia, and produced minimal side effects.

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