Effect of Dexmedetomidine infusion during hip fracture surgery on hemodynamic parameters and blood loss: A triple-blinded Randomized Clinical Trial

• Published in: Injury 2022-02, Vol.53 (2), p.551-554
• Main Authors: Hazrati, Ebrahim, Vosoughi, Fardis, Chamanara, Mohsen, Teymourian, Houman
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alpha agonist; Anesthesia, General; Bleeding; Dexmedetomidine; Double-Blind Method; Hemodynamics; Hip fracture; Humans; Iran; Middle Aged; Surgery
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2021.11.013

•Intravenous infusion of dexmedetomidine during hip fracture surgery significantly reduces intraoperative blood loss and surgical time.•Impact of intravenous dexmedetomidine on the hemodynamic parameters is not significant.•Dexmedetomidine can be considered as a safe, highly selective α2 agonist agent to help reduce intraoperative bleeding during hip fracture surgery. Introduction In this study, we aim to assess the intra-operative effect of dexmedetomidine administration on the hemodynamic parameters and bleeding volume during hip fracture surgery. Patients and methods we designed and implemented a triple-blinded randomized clinical trial to objectively compare the effects of 0.5 µg/kg/h infusion of dexmedetomidine with placebo (equal amount of normal saline) during hip fracture surgery. All included cases were between 30 and 70 years old and underwent surgery for fixation of a proximal femur fracture from September 26, 2020 until February 15, 2021. They were all ASA class I or II with preoperative hemoglobin levels of 10 mg/dL or higher. Surgical blood loss and hemodynamic parameters were documented. Results 76 patients were enrolled. There were no significant differences in baseline patient characteristics. The bleeding rate was 620 ± 190.0 mL for the normal saline group and 476 ± 177.98 mL in the dexmedetomidine group (P = 0.04). No significant effect on hemodynamic parameters was observed. Conclusion Based on the current study, intravenous infusion of dexmedetomidine during hip fracture surgery under general anesthesia reduced the amount of intraoperative bleeding without causing any significant hemodynamic disturbances. Registration number IRCT20191222045857N1 (Iranian Registry of Clinical Trials)