Effect of Dexmedetomidine Infusion During Orthopedic Surgery on Postoperative Analgesic Consumption in Opium Addict Patients; A Randomized Clinical Trial

Background: There are limited available scientific sources of data and rare controlled studies to guide the anesthesiologist regarding preoperative analgesic care in opioid addict patients, despite the increasing prevalence of opioid dependency. Objectives: In the present study, we aimed to evaluate the effect of using Dexmedetomidine (Dex) during femoral neck surgery on the postoperative analgesic consumption in opium addict patients. Patients and Methods: The present study is a double-blind randomized clinical trial. Patients suffering from femoral neck fracture with a history of opium addiction who were candidates for surgery under spinal anesthesia were included. After induction of spinal anesthesia using hyperbaric bupivacaine, either Dex or normal saline was infused for patients. Dex with a dose of 0.5g/kg/h in the intervention group and normal saline with a dose of 0.5 cc/kg/h in the control group was administered. After the surgery, pain intensity of the patients in recovery was assessed in 10-minute intervals based on visual analog scale (VAS) until 2 hours postoperatively. Time to pain and the total amount of opium consumption for pain control in 24 hours postoperatively were calculated and compared between the 2 groups. Results: Finally, 25 patients in each group were studied. Demographic and baseline characteristics of the patients in the 2 groups were not significantly different. Mean morphine consumption in recovery until 2 hours postoperatively showed no significant difference between Dex and control groups (P = 0.24). However, the mean opioid use during 24 hours postoperatively was significantly difference and it was lower in the group receiving Dex infusion (P < 0.001). Conclusions: It is likely that intravenous Dex infusion during femoral neck fracture surgery under spinal anesthesia can lead to the less opioid use throughout the 24 hours postoperatively in opium addict patients.