Dexmedetomidine as an intrathecal adjuvant to hyperbaric bupivacaine for postoperative analgesia in patients undergoing arthroscopic anterior cruciate ligament reconstruction surgeries

Background Dexmedetomidine is a particularly selective alpha-2 adrenergic agonist employed for premedication and as an adjunct to general anesthesia. It hinders the necessity for opioids and inhalational anesthetics. Aim This work aimed to measure the impact of adding low dosages of dexmedetomidine to hyperbaric bupivacaine during spinal anesthesia on postoperative analgesia characteristics in arthroscopic anterior cruciate ligament (ACL) reconstruction surgeries. Patients and methods This work had been conducted on 64 patients aged from 21 to 50 years old, planned for arthroscopic ACL reconstruction surgeries. Participants had been allocated into two groups equally: group I given the standard spinal anesthesia with 0.5% hyperbaric Bupivacaine and group II received the standard spinal anesthesia with 0.5% hyperbaric Bupivacaine plus dexmedetomidine 4 μg. Results Mean arterial pressure and heart rate had been insignificantly varied among the two groups. The total morphine amount used throughout the initial 24 h after surgery had been significantly reduced in group II contrasted to group I. Time to first rescue analgesics, duration of motor block and patient satisfaction were substantially greater in group II than in group I. Visual analog scale was significantly reduced at 2, 4, 8, and 12 h in group II contrasted to group I. Complications were insignificantly varied among both groups. Conclusions The low dosages of dexmedetomidine, when utilized as an adjunct to hyperbaric bupivacaine during spinal anesthesia demonstrated superior pain reduction, with a prolonged time to first rescue analgesics, lower opioid use, and higher patient satisfaction, contrasted to the use of hyperbaric bupivacaine alone in ACL reconstruction surgeries.