Comparing the effect of dexmedetomidine and remifentanil on recovery time of patients undergoing posterior spinal fusion surgery

Aim and The alpha-2 agonist dexmedetomidine, a potent sedative and analgesic by its central sympatholytic action, promotes hemodynamic stability. However it is unknown whether the recovery from anesthesia would be delayed with continuous infusion of dexmedetomidine because of its sedative effect. The aim of present study is to assess the effect of intravenous dexmedetomidine on postoperative recovery in elective posterior spinal fusion surgery. Forty patients were randomly divided into two equal groups; group R (remifentanil) received fentanyl 2 μg/kg + remifentanil 0.1 μg/kg and group D (dexmedetomidine) recieved fentanyl 2 μg/kg + dexmedetomidine 0.1 μg/kg over 10 min as premedication prior to induction. All of them received propofol 2mg/kg and Cis-Atracurium 0.2mg/kg for induction and then group R received remifentanil 0.1 μg/kg/min and group D had dexmedetomidine 0.1 μg/kg/h, both with propofol 100 μg/kg/min and Atracurium as intravenous infusion. Postoperative recovery was assessed by Aldrete’s score just at extubation, and every 10 min thereafter in recovery room. There was no significant difference in hemodynamic variables and the trend of Aldrete’s score between two groups. Aldrete’s score in group R was significantly higher than group D in the first evaluation in recovery room and 10 min after that (p<0.05). There was no significant delay in recovery time of group D patients. Sedative consumption and postoperative analgesic demand were insignificantly lower in group D. Dexmedetomidine maintains hemodynamic stability without significant delay in recovery time after general anesthesia in comparison with remifentanil. This property can make it as an alternative option for opioid medications.