20. Effect of dexmedetomidine on postoperative recovery in patients undergoing cervical spine surgery

Abstract

Objectives: Dexmedetomidine, ia a potent, alpha-2 agonist that has sedative, analgesic, anxiolytic and amnestic effects without respiratory. Present study is planned to evaluate the effect of Dexmedetomidine as an intraoperative analgesic and sedative and its effect on post-operative extubation, recovery profile and pain in patients of cervical spine surgeries. Methods: 35 adult patients with ASA I-II, with anterior cervical spine surgery were randomized. Study drug was started preinduction and continued till the last skin stitch. Dexmedetomidine was started at 0.2 lg/kg/h after loading dose of 1 lg/ kg. BIS score kept between 45 and 55. Perioperative hemodynamics, intraoperative fentanyl and sevoflurane consumption, and postoperative recovery profile, pain, fentanyl consumption was observed. Results: Total 35 patients were enrolled. Seventeen in the placebo and 18 in the study group. Time to emergence was earlier in Dexmed group (7.8 +/- 2.4 minutes) vs 10.5 +/- 3.7 minutes. Time to extubation was earlier in Dexmed group (9.8 +/- 3.1 minutes) versus 13.2 +/- 4.2 minutes. Pain score was lower in Dexmed group compared to placebo at extubation (2.8 +/- 9.6 vs. 26.2 +/- 22.2; P = <0.001) and in ICU (7.2 +/- 16.4 vs. 32.8 +/- 16.3). Time for 1st analgesic dose in postoperative period was later in Dexmed group (46.6 +/- 21.5 minutes vs. 18.7 +/- 14.7 minutes). Conclusion: Intraoperative use of dexmedetomidine in anterior cervical spine surgery results in a favorable recovery profile with reduced emergence/extubation time and postoperative pain.