Postoperative analgesia after wound infiltration with Dexmedetomidine and Ropivacaine versus Ropivacaine alone for lumbar discectomies: a randomized-controlled trial

Abstract

Introduction: Current LA may provide solid analgesic effect however, their analgesic advantages might be limited by their short life. Several reviews highlight the potential role of ?2-adrenergic receptors agonists like dexmedetomidine (DEX) for postoperative pain control.

Aim: Compare the analgesic efficacy of the sole LA: ropivacaine (R) with the combination of both: ropivacaine and DEX (RD) for wound infiltration (WI) in lumbar discectomies.

Methods: Prospective, randomized, double-blind, controlled study in nature. Adult patients undergoing elective lumbar discectomies were randomly allocated into two groups: group (R) received 2mg/kg with ropivacaine: 4.75 mg/ml in WI, group RD received the same dose of

ropivacaine as the first group adding 0.5 ug/kg of DEX. Visual analog scale

(VAS) at 0, 2, 6, 12, 18, and 24 hours (h); time to first rescue analgesia, total post-operative opiate dose was assessed during the first 24 h postoperatively.
Results: VAS values at all time intervals were significantly lower (p< 10-3) in the RD group as compared with the R group. The median time to first rescue analgesia was significantly shorter in the R group 8h [7-12] than RD group 21 h [18-24]. The median (interquartile range) opioid use was 3 [3-6] morphine mg equivalents in the R group and 0 [0-2] morphine mg equivalents in the RD group. The first time to mobilization was significantly shorter in RD group (22±03 h) than R group (27±06 h).