Comparison of dexmedetomidine versus midazolam on hemodynamic parameters, bleeding, satisfaction of surgeons and patients who underwent laminectomy surgery by spinal anesthesia

Abstract

Background: One of the most empirical subjects particularly in substantial operations for example in surgeries involving the vertebral column, are the implication of sedatives in a manner which would create the least complications such as changes in the hemodynamic parameters. Two such drugs that are widely used in this capacity in clinical settings are midazolam and dexmedetomidine. Hemodynamic stability is particularly important in surgical operations, especially during spinal surgery. One of the ways to prevent hemodynamic changes during surgery is the use of drugs such as midazolam and dexmedetomidine. Methods: This double-blind randomized clinical trial recruited 105 patients undergoing laminectomy spinal surgery under spinal anesthesia at Al-Zahra Hospital, Isfahan between 21 April 2019 till 1 September 2019. Patients were randomly divided into 3 groups: First was the midazolam group, second the dexmedetomidine group and the third was the control group. Data were presented as mean±standard deviation and percentages. In order for the evaluation of differences to be performed between all groups, an evaluation using the one-way analysis of variance was utilized. Statistical analysis was done by means of the SPSS software version 23 (IBM Corporation, Armonk, New York, USA). The P-value which was accepted as significant was P less than 0.05. (P<0.05) Results: There differences in age and gender were not statistically significant among the studied groups (p>0.05). Results from the ANOVA test showed that the effects when taking into consideration time (P<0.001) and group (P<0.001) were statistically significant on Mean of Arterial Pressure, Systole Blood Pressure and Diastole Blood Pressure. However, Heart Rate and oxygen saturation (SPO2) were not significantly different inter-group as well as intra-group over time (before, during, and after the operation) (P=0.12). Furthermore, the mean of the hemorrhage amount and duration of recovery stay had significant differences over time between all three groups (P<0.05). Conclusion: The incidence of complications during surgery in the dexmedetomidine group was less than the midazolam group. Additionally, the frequency of complications in the subjects given midazolam was higher than the dexmedetomidine group during recovery. Copyright © 2021 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.