Monitored Anesthesia Care in Minimally Invasive Spine Surgery-A Retrospective Case Series Study.

Area of Science:

• Anesthesiology
• Neurosurgery
• Spine Surgery

Background:

• Minimally invasive spine surgery (MISS) under monitored anesthesia care (MAC) is a growing treatment for spinal radiculopathy.
• Maintaining spontaneous respiration without endotracheal intubation is crucial for MISS in the prone position.

Purpose of the Study:

• To evaluate the feasibility and safety of using dexmedetomidine for MAC during MISS.
• To assess vital signs, sedation depth, and adverse events associated with dexmedetomidine in MISS patients.

Main Methods:

• Retrospective review of 17 patients undergoing MISS between September 2015 and June 2016.
• Analysis of vital signs, bispectral index (BIS), and need for rescue sedatives.
• Evaluation of adverse events including bradycardia, hypotension, and respiratory depression.

Main Results:

• All MISS procedures were completed successfully without airway complications or need for general anesthesia conversion.
• Median dexmedetomidine maintenance dose was 0.40 mcg/kg/hr; mean BIS was 76.46.
• Hypotension occurred in 35.3% and bradycardia in 17.6% of patients; four patients received rescue midazolam.

Conclusions:

• Monitored anesthesia care with dexmedetomidine is a feasible anesthetic approach for prone position MISS.
• Close monitoring for hypotension and bradycardia is essential when administering dexmedetomidine for MISS.