Comparison of the effect of dexmedetomidine with remifentanil on pain after lumbar laminectomy in patients under general anesthesia

Background. Acute postoperative pain is still an issue in patients undergoing lumbar laminectomy surgery. We compared the effects of remifentanil and dexmedetomidine on pain intensity as well as the analgesic requirements in patients undergoing spinal surgery.

Methods. This randomized clinical trial study was conducted on 60 patients in the age range of 20 to 60 years with ASA (American Anesthesia Association) class one and two who underwent elective lumbar vertebrae laminectomy. Patients were divided into two groups: Remifentanil (group R) and Dexmedetomidine (group D). Before the induction of anesthesia in R group patients, 0.01 μg/kg/min remifentanil was used. In group D, 0.3 µg/min/kg dexmedetomidine was injected using a syringe pump. Postoperative pain score, nausea, vomiting, mean arterial blood pressure, and heart rate at recovery times, 6, 12, and 24 hours after surgery were recorded.

Results. The propofol infusion rate was significantly lower in group D than in group R (P=0.001). Pain scores except for 6-hours after surgery was significantly lower in group D. Analgesic consumption was significantly lower in group D (P=0.021). Mean arterial pressure during surgery, after laryngoscopy, and recovery was significantly lower in group D (P<0.05). The mean heart rate after laryngoscopy was significantly lower in group D (P=0.033).

Conclusion. Intraoperative infusion of dexmedetomidine improved hemodynamic parameters during surgery and decreased pain score and morphine use after lumbar laminectomy surgery.