Dexmedetomidine versus nimodipine for controlled hypotension during spine surgery

Mohamed, Hatem Saber; Asida, Salah M.; Salman, O. H.

doi:10.1016/j.egja.2013.06.002

Cited by 4 publications

(3 citation statements)

References 19 publications

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“…Controlled hypotension can be achieved using various medications. [226][227][228][229][230][231][232] According to the 2019 practice advisory update from the ASA Task Force on Perioperative Visual Loss, the North American Neuro-Ophthalmology Society, and the SNACC, deliberate hypotension should only be used on a case-by-case basis. 214 Recommendation: (1) Information related to baseline blood pressure, the presence of neurological deficits, and preexisting endorgan injury may influence intraoperative mean arterial blood pressure targets which must be individualized to the patient (Class I, Level of Evidence C-EO).…”

Section: Blood Pressure Targetsmentioning

confidence: 99%

“…However, specific blood pressure targets for complex spine surgery are not defined. Controlled hypotension can be achieved using various medications 226–232. According to the 2019 practice advisory update from the ASA Task Force on Perioperative Visual Loss, the North American Neuro-Ophthalmology Society, and the SNACC, deliberate hypotension should only be used on a case-by-case basis 214…”

Section: Evidence-based Clinical Practice Guidelines and Recommendationsmentioning

confidence: 99%

See 1 more Smart Citation

Perioperative Care of Patients Undergoing Major Complex Spinal Instrumentation Surgery: Clinical Practice Guidelines From the Society for Neuroscience in Anesthesiology and Critical Care

Blacker

Vincent

Burbridge

et al. 2021

Journal of Neurosurgical Anesthesiology

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Evidence-based standardization of the perioperative management of patients undergoing complex spine surgery can improve outcomes such as enhanced patient satisfaction, reduced intensive care and hospital length of stay, and reduced costs. The Society for Neuroscience in Anesthesiology and Critical Care (SNACC) tasked an expert group to review existing evidence and generate recommendations for the perioperative management of patients undergoing complex spine surgery, defined as surgery on 2 or more thoracic and/or lumbar spine levels. Institutional clinical management protocols can be constructed based on the elements included in these clinical practice guidelines, and the evidence presented.

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Section: Blood Pressure Targetsmentioning

confidence: 99%

Section: Evidence-based Clinical Practice Guidelines and Recommendationsmentioning

confidence: 99%

Perioperative Care of Patients Undergoing Major Complex Spinal Instrumentation Surgery: Clinical Practice Guidelines From the Society for Neuroscience in Anesthesiology and Critical Care

Blacker

Vincent

Burbridge

et al. 2021

Journal of Neurosurgical Anesthesiology

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show abstract

“…Mohamed et al . [21] and Nazir et al . [22] reported a significant reduction in fentanyl requirement with dexmedetomidine during spine surgery.…”

Section: Discussionmentioning

confidence: 99%

Effect of a low-dose dexmedetomidine infusion on intraoperative hemodynamics, anesthetic requirements and recovery profile in patients undergoing lumbar spine surgery

Kundra

Taneja

Choudhary

et al. 2019

J Anaesthesiol Clin Pharmacol

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Background and Aims: Dexmedetomidine has been used as an anesthetic adjuvant; however, hypotension is a concern especially in prone patients. The aim of the study was to evaluate the effect of a low-dose dexmedetomidine infusion on intraoperative hemodynamics, blood loss, anesthetic requirements, and recovery profile in patients undergoing lumbar spine surgery in the prone position. Material and Methods: The study was conducted in a randomized double-blinded manner in 60 patients scheduled for one- or two-level lumbar laminectomy. After administration of general anesthesia, patients were placed in prone position and allocated to either of two groups of 30 patients each. Patients in Group A received dexmedetomidine infusion at the rate of 0.3 μg kg -1 hr -1 , whereas, group B patients received a saline infusion. The depth of anesthesia was guided by Bispectral index (BIS) monitoring, maintaining BIS between 40 and 60. Results: The demographic profile and duration of surgery in both groups were similar. Mean heart rate was statistically similar in both the groups. Mean blood pressure was lower in group A, though the difference was significant only for the initial 30 min. The mean end-tidal sevoflurane requirement in group A was significantly less than that in group B ( P = 0.003). Patients in group A had better recovery profile with mean emergence, extubation, and recovery times of 8.08 ± 3.48 min, 9.37 ± 3.64 min, and 11.65 ± 4.03 min, respectively, as compared with 11.27 ± 3.05 min, 12.24 ± 2.39 min, and 14.90 ± 2.63 min, respectively, in group B ( P < 0.001). Mean intraoperative blood loss in group A of 263.47 ± 58.66 mL was significantly lower than 347.67 ± 72.90 ml in group B ( P = 0.0001). Conclusion: Group A patients had stable hemodynamic parameters, reduced intraoperative blood loss, less anesthetic requirement, and could be extubated earlier as compared with group B patients.

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Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery

Duncan

Sankar

Beattie

et al. 2018

Cochrane Database of Systematic Reviews

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Our review concludes that prophylactic α-2 adrenergic agonists generally do not prevent perioperative death or major cardiac complications. For non-cardiac surgery, there is moderate-to-high quality evidence that these agents do not prevent death, myocardial infarction or stroke. Conversely, there is moderate quality evidence that these agents have important adverse effects, namely increased risks of hypotension and bradycardia. For cardiac surgery, there is moderate quality evidence that α-2 adrenergic agonists have no effect on the risk of mortality or myocardial infarction, and that they increase the risk of bradycardia. The quality of evidence was inadequate to draw conclusions regarding the effects of alpha-2 agonists on stroke or hypotension during cardiac surgery.

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Dexmedetomidine versus nimodipine for controlled hypotension during spine surgery

Cited by 4 publications

References 19 publications

Perioperative Care of Patients Undergoing Major Complex Spinal Instrumentation Surgery: Clinical Practice Guidelines From the Society for Neuroscience in Anesthesiology and Critical Care

Perioperative Care of Patients Undergoing Major Complex Spinal Instrumentation Surgery: Clinical Practice Guidelines From the Society for Neuroscience in Anesthesiology and Critical Care

Effect of a low-dose dexmedetomidine infusion on intraoperative hemodynamics, anesthetic requirements and recovery profile in patients undergoing lumbar spine surgery

Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery

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