RESEARCH ARTICLE
Efficacy of Dexmedetomidine Infusion Without Loading Dose as a Potent Hypotensive Agent in Lumbar Fixation Surgery
Assem Adel Moharram1, Raham Hasan Mostafa1, *
Article Information
Identifiers and Pagination:
Year: 2019Volume: 13
First Page: 68
Last Page: 74
Publisher ID: TOATJ-13-68
DOI: 10.2174/2589645801913010068
Article History:
Received Date: 30/05/2019Revision Received Date: 19/07/2019
Acceptance Date: 4/08/2019
Electronic publication date: 30/08/2019
Collection year: 2019
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
Dexmedetomidine on the basis of the previous literature can be considered a safe agent for controlled hypotension through its central and peripheral sympatholytic action. Its easy administration and absence of fatal side effect make it a near-ideal hypotensive agent. This study was intended to evaluate the efficacy of dexmedetomidine infusion “without loading dose” as an effective hypotensive agent in lumbar fixation surgery.
Methods:
In a double-blind study, a total of 60 patients aged 18-65 years, of both genders, belonging to the American Society of Anesthesiologist (ASA) class I II scheduled for elective lumbar spine instrumentation were included and divided into: Control group (Group C) who received placebo and Dexmedetomidine group (Group D) who received Intravenous (IV) dexmedetomidine. The patients were compared primarily for intraoperative hemodynamics.
Results:
The study results showed that dexmedetomidine had successfully maintained target mean blood pressure of 65-70 mmHg and only 2 patients out of 30 required rescue therapy (both of propofol and NG). Also, dexmedetomidine had maintained heart rate stability than the control group from the 15th minute after positioning till the end of surgery (P-value < 0.001). Intraoperative fentanyl consumption was significantly low in Dexmedetomidine group 75 ± 25.43 µg versus 169.64 ± 34.26 µg in Control group (P-value < 0.001). Finally, more post-operative sedation was noticed during the 1st postoperative hour in dexmedetomidine group when compared to the control group (P-value < 0.001).
Conclusion:
Dexmedetomidine infusion without loading dose could be an effective and safe agent in achieving controlled hypotension in adults undergoing elective lumbar spine instrumentation surgery with limited side effects together with intraoperative opioid-sparing effect.