title: Intraoperative and Postoperative Administration of Dexmedetomidine Reduces Anesthetic and Postoperative Analgesic Requirements in Patients Undergoing Cervical Spine Surgeries.
abstract: BACKGROUND
  Early recovery from anesthesia and avoidance of analgesics with respiratory depressant properties are vital for maintenance of extubated airway in cervical spine surgeries. The current study investigated the role of dexmedetomidine as an anesthetic sparing agent and as a sole postoperative analgesic in these cases.
  
  
  METHODS
  Sixty adult patients undergoing cervical spine surgeries were randomized into 2 groups. Group D received intravenous dexmedetomidine infusion 0.5 μg/kg/h throughout the surgery after a loading dose of 1 μg/kg over 10 minutes. Postoperatively, dexmedetomidine infusion was continued at 0.2 μg/kg/h for 24 hours. Group C received a volume-matched bolus and infusion of 0.9% saline. Intraoperative anesthetic requirement, time to recovery, and discharge were recorded. Patients were observed for rescue analgesic requirements for 24 hours after surgery. Hemodynamic stability, sedation scores, and pain scores were assessed for 48 hours after surgery.
  
  
  RESULTS
  There was significant reduction in intraoperative anesthetic requirement in group D (P<0.001). Although sedation scores and recovery criteria were comparable, pain scores were significantly lower in group D compared with group C for first 24 hours postoperatively at all corresponding times. The mean pain-free period after surgery was significantly longer in group D (1460.67±517.16 min) with significantly less rescue analgesic requirement during 24-hour postoperative period (P=0.018) compared with group C (98.17±81.20 min). Hemodynamic parameters were maintained within clinically normal range during study period.
  
  
  CONCLUSIONS
  Dexmedetomidine lowered the anesthetic requirement with clinically permissible hemodynamic variations without undue prolongation of recovery time. Postoperative dexmedetomidine infusion provided effective analgesia without excessive sedation in patients undergoing cervical spine surgeries.
authors.affiliation: *Department of Anaesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh †Sudha Institute of Medical Sciences, Erode, Tamilnadu, India.
authors.forename: Komal A
authors.initials: KA
authors.lastname: Gandhi
authors.forename: Nidhi B
authors.initials: NB
authors.lastname: Panda
authors.forename: Amutha
authors.initials: A
authors.lastname: Vellaichamy
authors.forename: Preethy J
authors.initials: PJ
authors.lastname: Mathew
authors.forename: Neeru
authors.initials: N
authors.lastname: Sahni
authors.forename: Yatindra K
authors.initials: YK
authors.lastname: Batra
mesh_terms: D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use; D000758:Anesthesia; D002574:Cervical Vertebrae / Q000601:surgery*; D020927:Dexmedetomidine / Q000008:administration & dosage; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D007262:Infusions, Intravenous; D007430:Intraoperative Care; D053208:Kaplan-Meier Estimate; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods*; D010147:Pain Measurement / Q000187:drug effects; D010149:Postoperative Pain / Q000517:prevention & control*; D011182:Postoperative Care; D013131:Spine / Q000601:surgery*
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine