Rahimi Zahra, Nazemroaya Behzad, Honarmand Azim, Meshkin Negar, Maghami Mehr Asieh
Department of Anesthesiology, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Statistics, School of Mathematics, Yazd University, Yazd, Iran.
Adv Biomed Res. 2025 Jul 31;14:76. doi: 10.4103/abr.abr_515_24. eCollection 2025.
Reducing bleeding in lumbar vertebrae fusion surgery is essential to maintain the patient's hemodynamic stability and create a favorable view. This study aims to compare and contrast the effects of dexmedetomidine and magnesium sulfate on lumbar laminectomy surgery.
This double-blind randomized clinical trial was conducted on 70 patient underwent lumbar fusion surgery. They were randomly divided into two groups of 35. After inducing general anesthesia with an infusion pump, the first group (MgSO4 group) received an intravenous injection of 60 mg/kg of 50% magnesium sulfate, diluted in 100 cc of normal saline, for 15 minutes. In the second group (DEX group), a dexmedetomidine infusion was started before anesthesia with a dose of 1 μg/kg every 10 minutes. Dexmedetomidine infusion at a rate of 0.5 μg/kg/hour was continued until the end of the surgical procedure. Systolic and diastolic pressure (SBP, DBP), mean atrial pressure (MAP), heart rate (HR), and SPO2, was recorded before surgery and every 30 minutes during surgery. Also, the intraoperative bleeding and side effect were recorded.
The results of this study showed that SBP and MAP of the DEX group at 30 and 60 minutes were significantly lower than the MgSO4 group. The DBP of the DEX group was significantly lower than the MgSO4 group only in the 30 minute. Intraoperative bleeding, packed-cell transfusion, tachycardia, and quality of the surgical field were significantly lower in the DEX group.
Considering that the administration of DEX has been more effective in controlling intraoperative bleeding and better quality of surgical field, it seems that the administration of DEX is more preferable than MgSO4.
减少腰椎融合手术中的出血对于维持患者的血流动力学稳定和创造良好视野至关重要。本研究旨在比较和对比右美托咪定和硫酸镁对腰椎椎板切除术的影响。
本双盲随机临床试验对70例行腰椎融合手术的患者进行。他们被随机分为两组，每组35人。在用输液泵诱导全身麻醉后，第一组（硫酸镁组）静脉注射60mg/kg的50%硫酸镁，用100cc生理盐水稀释，持续15分钟。第二组（右美托咪定组）在麻醉前开始输注右美托咪定，剂量为每10分钟1μg/kg。以0.5μg/kg/小时的速率持续输注右美托咪定直至手术结束。记录手术前及手术期间每30分钟的收缩压和舒张压（SBP、DBP）、平均动脉压（MAP）、心率（HR）和血氧饱和度（SPO2）。同时，记录术中出血情况和副作用。
本研究结果显示，右美托咪定组在30分钟和60分钟时的SBP和MAP显著低于硫酸镁组。右美托咪定组的DBP仅在30分钟时显著低于硫酸镁组。右美托咪定组的术中出血、红细胞压积输血、心动过速和手术视野质量显著更低。
考虑到右美托咪定在控制术中出血和提高手术视野质量方面更有效，似乎右美托咪定的应用比硫酸镁更可取。
