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To Study the Efficacy and Heamodynamic Response to Dexmedetomidine as Hypotensive Agent in Elective Spine Surgeries

VRR Chari , Smruti Govekar , VRR Chari , Amey Sable , Ashwini Khamborkar

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Indian Journal of Anesthesia and Analgesia 7(1):p 382-388, January-February 2020. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.52

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Smruti Govekar, VRR Chari, Amey Sable et al. To Study the Efficacy and Heamodynamic Response to Dexmedetomidine as Hypotensive Agent in Elective Spine Surgeries. India J Anesth Analg. 2020;7(1 Part -II):382-388.

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Abstract

Background: Spine surgeries require reduced intraoperative blood pressures to make better visualization of surgical site. Deliberate hypotension or controlled hypotension have been preferred technique used for many surgical procedures to attain clear surgical fields. Aim: The aim of our study is to evaluate the efficacy and hemodynamic response to IV Dexmedetomidine and placebo [Normal saline] as hypotensive agent in elective spine surgeries. Methods: Sixty patients between age group of 18–60 years were selected who were posted for elective spine surgeries. They were divided into two groups of 30 each i.e. Dexmedetomidine Group and Normal Saline Group and were be given their respective drug. Group D: Inj. Dexmedetomidine 100 mcg [diluted in 50 ml of 0.9% Normal saline]. Group N: 50 ml of 0.9% of normal saline. Patients in the D Group received 1 mcg/kg infusion (diluted in 50 ml of 0.9% normal saline) over a period of 10 min prior to premedication. After induction of anesthesia, patients in the D Group received a continuous infusion of Dexmedetomidine at 0.2 mcg/kg/h, whereas patients in the N Group received infusion of Normal saline at same dose as dexmedetomidine. The hemodynamic parameters Pulse Rate (PR), Systolic Blood Pressure, Diastolic Blood Pressure and Mean Arterial Blood Pressure (SBP, DBP, MAP), Respiratory Rate (RR), SpO2 were studied in all the groups at baseline, after giving drug, after intubation, 15 minutes, 30 minutes and 45 minutes, 60 minutes, 75 minutes, 90 minutes, 105 minutes, 120 minutes, after stopping drug and after extubation. Postoperative sedation score was also measured. Patient were shifted to postanesthesia care unit and monitored for hemodynamic parameters, Ramsay sedation score and adverse effects if any. The statistical analysis was done based on Student’s t-test for continuous variables and Chi-square test for categorical variables. Final interpretation will be based on Z-test with 95% level of significance. Results: Patients in D Group achieved desired MAP as compared to normal saline (placebo) group with good control over heart rate. With no significant difference in postoperative sedation score was found in patients with Dexmedetomidine group as compared to normal saline (placebo). Conclusion: Dexmedetomidine is an effective drug for achieving controlled hypotension and thus, can be used as hypotensive agent in spine surgery to maintain clear surgical field.

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Smruti Govekar, VRR Chari, Amey Sable et al. To Study the Efficacy and Heamodynamic Response to Dexmedetomidine as Hypotensive Agent in Elective Spine Surgeries. India J Anesth Analg. 2020;7(1 Part -II):382-388.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7120.52

Keywords

Hypotension; Deliberate hypotension; Dexmedetomidine; Spine surgery; Surgical field.

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