Use of Dexmedetomidine and Esmolol for Hypotension in Lumbar Spine Surgery

BACKGROUND The importance of decreasing bleeding in spine surgery is not only important to maintain the patient's hemodynamic balance but also allow a better view of the surgical field. OBJECTIVES The current study aimed to compare dexmedetomidine and Esmolol™ as agents to induce hypotension in lumbar spine surgeries. PATIENTS AND METHODS A total of 50 patients aged 20 to 65 years belonging to the American society of anaesthesiologist (ASA) class I - II scheduled for decompression and fixation of the lumbar spine were included and divided into two groups namely, Group I, who received Esmolol and group II, who received dexmedetomidine, intravenously. The patients were compared for intraoperative hemodynamic parameters, estimated blood loss, operation time, intraoperative analgesic (fentanyl) consumption, and total fall in haemoglobin (Hb) during the perioperative period. RESULTS The study results showed that dexmedetomidine had lower (100.8 µg) fentanyl and sevoflurane consumption (1.2%), and less blood loss (278 mL) in comparison to the Esmolol group. CONCLUSIONS Both dexmedetomidine and Esmolol can be used as agents to control hypotension in patients undergoing lumbar spine decompression and fixation surgery; the dexmedetomidine group, however, was associated with better intraoperative hemodynamic stability and reduced intraoperative analgesic and volatile anaesthetic requirement.