Use of Dexmedetomidine as an Adjuvant in Spinal Anesthesia in Patients With Femoral Fracture Affected by Moderate Aortic Stenosis: A Case Series

The anaesthesiological management of femoral fracture in the frail patient still represents a challenge for the anaesthetist and his team. For decades, the most frequently used anaesthesiological approach in these cases has been spinal anaesthesia. In recent years, the progression of pharmacology and anaesthesiological techniques has meant that this technique can be adopted in situations where general anaesthesia was previously preferred, particularly in clinical scenarios requiring less haemodynamic impact, such as in patients with aortic valve stenosis. In this case series, we consider how adjuvant spinal anaesthesia with dexmedetomidine ensures adequate intra- and post-operative analgesia and haemodynamic stability in patients with moderate aortic valvular stenosis. Specifically, we used the Visual Analogue Scale (VAS) score to evaluate pain, both intraoperatively and postoperatively at 6, 12, and 24 hours.