[Effect of dexmedetomidine infusion on postoperative recovery for patients undergoing major spinal surgery during propofol anesthesia].
OBJECTIVE
To evaluate the effect of intraoperative dexmedetomidine (DEX) infusion during propofol intravenous anesthesia on postoperative recovery after major spinal surgery.


METHODS
Sixty patients aged 18 to 65 (American Society of Anesthesiologists, ASA I-II), scheduled for spinal surgery from January 2014 to May 2014 were randomized into two groups. The DEX group (n=30) received 0.5 μg/kg of DEX ten minutes before anesthesic induction, followed by an infusion of DEX at 0.2 μg/(kg×h) intraoperatively and the control group (n=30) was given identical amounts of normal saline. At the end of surgery, the patients of both groups received patient-controlled intravenous analgesia (PCIA) with morphine 0.5 mg/h (1 mg demand dose and 8 min lockout). Heart rate and mean arterial pressure (MAP) were continually monitored during operation and in the post-anesthesia care unit (PACU). The propofol and sufentanil consumptions during operation and the morphine consumption 48 h after surgery were recorded. The time for recovery and extubation were recorded. The followed-up evaluations were performed to assess Ramsay scores, visual analogue scale (VAS) pain scores as well as side effects in PACU and 48 h after surgery.


RESULTS
Heart rate of DEX group was lower than that of control group after intubation and extubation and in PACU 10 min (P<0.05). MAP was lower in DEX group than that in control group after extubation and in PACU (P<0.05). Compared with control group, the propofol consumption during anesthesic induction, the sufentanil consumption during operation and the cumulative consumption of morphine 2 h and 6 h after surgery were decreased (P<0.05). There were no differences between the two groups as to the time for recovery or extubation. Compared with control group, the VAS pain scores were significantly decreased (P<0.01), the incidence of postoperative nausea and vomiting in DEX group were significantly decreased (P<0.05) 48 h after surgery.


CONCLUSIONS
Intraoperative infusion of DEX improved quality of recovery, provided good analgesia, and decreased morphine use and the incidence of postoperative nausea and vomiting after major spinal surgery.
Department of Anesthesiology, Peking University First Hospital, Beijing 100034, China.
B Y
BY
Li
Department of Anesthesiology, Peking University First Hospital, Beijing 100034, China.
Z Y
ZY
Geng
Department of Anesthesiology, Peking University First Hospital, Beijing 100034, China.
D X
DX
Wang
D000293:Adolescent; D000328:Adult; D000368:Aged; D000698:Analgesia; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000762:Anesthesia Recovery Period; D000771:Anesthesia, Intravenous; D020927:Dexmedetomidine / Q000008:administration & dosage*; D006339:Heart Rate; D006801:Humans; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D019635:Neurosurgical Procedures; D015742:Propofol / Q000008:administration & dosage*; D017409:Sufentanil / Q000008:administration & dosage; D014839:Vomiting / Q000517:prevention & control; D055815:Young Adult
D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine; D009020:Morphine; D017409:Sufentanil; D015742:Propofol