Use of dexmedetomidine for postoperative analgesia in spine patients

Postoperative spinal patients remain a challenge for provision of postoperative analgesia. They often exhibit tolerance to narcotics, which requires alternative agents. Our institution has an experience with the use of dexmedetomidine for postoperative analgesia in spine patients.

This was conducted as a retrospective chart review of spine patients that received dexmedetomidine during an entire calendar year, and we excluded any patients that were mechanically ventilated or received other sedation agents.

Twenty-nine patients were identified that received the dexmedetomidine for a mean of 31.3 hours, at a mean rate of 0.5 mcg/kg/hour. Their mean pain score went from 7.1 to 1.6 (P<0.001) within 4 hours of starting the drug. Both the heart rate, and systolic blood pressure decreased by approximately 10% after starting the dexmedetomidine. In 4 patients (13.8%) the dexmedetomidine had to be stopped early on due to bradycardia or hypotension.

Dexmedetomidine represents an important agent for the treatment of severe postoperative spinal pain as a supplemental agent with patients that do not achieve adequate analgesia from narcotics.