Introduction
Method
Trial design and participants
Inclusion criteria | Exclusion criteria |
---|---|
1. Low back pain and/or leg pain, and MRI confirmed central canal stenosis, or lateral recess stenosis or intervertebral foramen stenosis of lumbar vertebra 2. Segments of lumbar spinal fusion < 3 3. Duration of symptoms and conservative treatment > 3 months 4. American Society of Anesthesiologists (ASA) physical status classes I and II 5. Patient-controlled analgesia device (PCA) can be used independently | 1. Previous lumbar spine surgery 2. Myelopathy, cauda equine syndrome or other spinal conditions (cancer, rheumatologic disorders, neurologic disorders) 3. Ischemic heart disease; bradycardia (heart rate < 50 beats/min) with or without cardiac conduction or arrhythmia; diabetes mellitus; severe osteoporosis; neuromuscular and endocrine diseases; coagulation disorders; adrenoreceptor agonist or antagonist therapy; allergy to the study drugs 4. Recent or previous history of alcohol, opioid or narcotic drug dependence 5. Chronic pain syndromes 6. Pregnant or lactating women |
Randomization and blinding
Interventions
Outcomes
Statistical analysis
Results
Group R | Group R + DXM | Group R + DEX | Group R + DXM + DEX | P value | |
---|---|---|---|---|---|
Duration of analgesia (min) | 550.00 ± 270.10 | 600.22 ± 398.25 | 767.22 ± 436.86 | 743.89 ± 389.07 | 0.242 |
Total hydromorphone consumption (mg) | 2.49 ± 1.88 | 2.34 ± 2.03 | 2.83 ± 1.61 | 2.36 ± 1.38 | 0.819 |
Side effects | Group R | Group R + DXM | Group R + DEX | Group R + DXM + DEX | P value |
---|---|---|---|---|---|
Bradycardia | 0 (0) | 0 (0) | 0 (0) | 0 (0) | – |
Hypotension | 0 (0) | 0 (0) | 0 (0) | 0 (0) | – |
Hypoxemia | 0 (0) | 0 (0) | 0 (0) | 0 (0) | – |
Respiratory depression | 0 (0) | 0 (0) | 0 (0) | 0 (0) | – |
Pruritus | 0 (0) | 0 (0) | 0 (0) | 0 (0) | – |
Neurotoxicity | 0 (0) | 0 (0) | 0 (0) | 0 (0) | – |
Nausea/vomiting | 1 (0) | 0 (0) | 2 (11.1) | 2 (11.1) | 0.237 |
Dizziness | 0 (0) | 0 (0) | 1 (5.6) | 1 (5.6) | 0.561 |
Delayed anesthesia recovery | 0 (0) | 0 (0) | 4 (22.2) | 3 (16.7) | 0.045 |
Group R | Group R + DXM | Group R + DEX | Group R + DXM + DEX | P value | |
---|---|---|---|---|---|
Age (years) | 55.06 ± 10.70 | 56.28 ± 5.77 | 54.11 ± 7.10 | 56.44 ± 8.70 | 0.386 |
BMI (kg/m2) | 23.22 ± 3.27 | 23.91 ± 3.79 | 24.87 ± 3.24 | 23.24 ± 3.20 | 0.422 |
Gender (male/female) | 9:9 | 6:12 | 10:8 | 7:11 | 0.522 |
ASA class (I/II) | 3:15 | 1:17 | 2:16 | 2:16 | 0.771 |
aCCI | 1.33 ± 1.09 | 1.28 ± 0.75 | 1.00 ± 1.03 | 1.44 ± 0.92 | 0.378 |
Duration of surgery (hour) | 4.28 ± 1.02 | 4.06 ± 0.54 | 3.78 ± 1.26 | 4.31 ± 1.05 | 0.485 |
Fusion levels (1/2) | 11:7 | 12:6 | 12:6 | 12:6 | 0.980 |