Prospective randomized controlled study to compare the postoperative analgesic efficacy of intravenous dexmedetomidine and pethidine on patients undergoing lumbosacral spine surgeries

Introduction: Spine surgeries, especially spine fusion surgeries cause severe postoperative pain, hampering convalescence. This is a randomized double blind controlled study comparing the analgesic efficacy of postoperative intravenous pethidine and dexmedetomidine in patients undergoing lumbosacral spine surgeries. Materials and Methods: After connecting patients to vital parameters monitor, patients were given general anaesthesia, induced with fentanyl 2mcg/kg, propofol 2mg/kg in graded doses and rocuronium 0.6mg/kg to facilitate tracheal intubation. All patients received 1 gram paracetamol iv slow infusion intraoperatively. After one and a half hours of surgery, injection fentanyl 1mcg/kg was repeated. After extubation and shifting the patients to PACU, patients were randomly allotted either group P/pethidine group or group D/dexmedetomidine group by computerised randomization. Group P patients received injection pethidine 0.5mg/kg loading dose diluted in 5 ml of distilled water slow iv, followed by 0.15mg/kg/hr infusion for 24hrs. Group D patients received injection dexmedetomidine 1mcg/kg bolus over 15 minutes followed by infusion of 0.5mcg/kg/min. Pulse rate, blood pressure, oxygen saturation, respiratory rate, VAS score and sedation score were monitored every 5 minutes for first 15 minutes, every 15 minutes for 1 hour, every hour till 6th hour, then 12th hour, and 24th hour. Results: Dexmedetomidine has a faster on set of analgesic effect (10 minutes) compared to pethidine (30 minutes), provides better analgesia and manageable hemodynamics but, causes more sedation with an average sedation score of 2.83 compared to pethidine. Conclusion: Dexmedetomidine is a better analgesic in the postoperative period compared to pethidine.