Dexmedetomidine as an alternative to general anesthesia in vertebroplasty and kyphoplasty: a safety and efficacy study

PURPOSE: To evaluate the effectiveness and safety of dexmedetomidine during vertebroplasty and kyphoplasty surgery in patients with vertebral compression fractures due to malignancy and osteoporosis. METHODS: This retrospective study included 41 patients, comprising 22 with osteoporosis and 19 with malignant conditions. Perioperative systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), oxygen saturation (SpO2), Visual Analog Scale (VAS) scores, complications, as well as the duration of the operation and anesthesia, were recorded. Additionally, the investigators’ satisfaction scores were documented. RESULTS: All parameters (SBP, DBP, HR, and SpO2) showed statistically significant temporal variations from baseline values (p < 0.001). SBP decreased significantly from the 5th minute onward, while DBP and HR exhibited significant reductions beginning at the 10th minute. These decreases, although statistically significant, were clinically expected and manageable, aligning with the known pharmacodynamic profile of dexmedetomidine. In contrast, SpO2 values demonstrated significant increases at the 15th and 30th minutes, indicating preserved respiratory stability. The median preoperative VAS score was 6 (range: 1–10), while the median score at 60 min postoperatively was 1 (range: 0–3). The median operator satisfaction score was 3 (range: 1–3). CONCLUSIONS: In minimally invasive surgery for vertebral compression fractures, particularly in elderly patients with comorbidities, dexmedetomidine sedoanalgesia appeared to be a well-tolerated and feasible option for achieving adequate sedation and pain control. Nevertheless, due to the retrospective design and limited sample size, further prospective and controlled studies are required to confirm these findings and better define its role in clinical practice.