The Effect of Dexmedetomidine and Magnesium Sulfate Administration in Controlling Intraoperative Bleeding in Lumbar Laminectomy Surgery: A Randomized Clinical Trial.

BACKGROUND

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.

MATERIALS AND METHODS

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.

RESULTS

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.

CONCLUSIONS

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.