Objectives: to determine the effect of intravenous infusions of dexmedetomidine, nitroglycerine and magnesium sulfate on the Intraoperative opioid consumption and to compare their effects on intraoperative hemodynamics, stress hormones, blood loss, degree of sedation postoperatively, the time required to restore mean arterial pressure (MAP) to baseline after cessation of infusion, and to calculate the time of first analgesic request postoperatively. Background: Controlled hypotension is a method to reduce the blood loss, the need for blood transfusion during surgery, improves the visibility of surgical site and decreases the duration of surgery. Methods: Sixty adult patients (20–60 years of age) of both sexes with the American Society of Anesthesiologists physical status class I or II undergoing elective open lumbar fixation surgeries under general anesthesia classified into 3 groups where dexmedetomidine, nitroglycerine and magnesium sulfate were used. Results: The patients who need intraoperative rescue of analgesia were significantly less in group D followed by group M and all patients in group N need intraoperative rescue of analgesia (p= 0.0001). The desired range of MAP was achieved in all groups. The epinephrine blood level was significantly less in group D in comparison to group M and group N during deliberate hypotension and in postoperative period (p= 0.001) Conclusion: Dexmedetomidine was superior to magnesium sulfate and nitroglycerine for providing a good intraoperative analgesia state with a controlled hypotensive anesthesia and antistress effect, however, it was associated with prolonged sedation.
Afify, Noha A.; Attallah, Hatem A.; Tieama, Mohamed A.; and Fathy, Yasser I.
"Efficacy of dexmedetomidine, nitroglycerine, magnesium sulfate infusions as a hypotensive agent in lumbar fixation surgeries,"
Menoufia Medical Journal: Vol. 36:
2, Article 5.