Intravenous Dexmedetomidine as an Adjunct to Spinal Anesthesia for Lower-Extremity Orthopedic Surgery: A Randomized Controlled Study

Question: This study evaluated its effect on sensory and motor block characteristics and perioperative hemodynamics during lower-extremity orthopedic surgery.
Finding: Between-group blood pressure differences did not meet the prespecified p<0.05 threshold.
Meaning: Intravenous dexmedetomidine was associated with longer sensory and motor block duration and modestly faster block onset, but also with lower perioperative heart rate.

Article summary

Abstract

Background

Intravenous dexmedetomidine may prolong spinal anesthesia but can reduce heart rate and blood pressure. This study evaluated its effect on sensory and motor block characteristics and perioperative hemodynamics during lower-extremity orthopedic surgery.

Methods

In this single-center randomized controlled study, 25 adults with American Society of Anesthesiologists physical status I-II undergoing lower-extremity surgery under spinal anesthesia were allocated by sealed-envelope selection to dexmedetomidine (Group D; n=12) or saline control (Group C; n=13). All patients received 10 mg intrathecal isobaric bupivacaine. Group D received intravenous dexmedetomidine 1 µg/kg over 10 minutes followed by 0.2 µg/kg/h; Group C received volume-matched 0.9% saline. Sensory block was assessed by pinprick, motor block by the Bromage scale, and heart rate and blood pressure at prespecified perioperative time points. Between-group comparisons used the Mann-Whitney U test.

Results

Median sensory block onset was 1.0 versus 1.2 minutes (p=0.040) and motor block onset was 2.0 versus 2.5 minutes (p=0.025) in Groups D and C, respectively. Sensory block duration was 125 versus 85 minutes (p<0.001), and motor block duration was 102.5 versus 65 minutes (p=0.002). Heart rate was lower in Group D after the spinal technique and at 15 minutes, 40 minutes, the end of infusion, and 40 minutes after infusion (all p<0.05). Between-group blood pressure differences did not meet the prespecified p<0.05 threshold. No severe hemodynamic events were reported in the source study.

Conclusions

Intravenous dexmedetomidine was associated with longer sensory and motor block duration and modestly faster block onset, but also with lower perioperative heart rate. Given the small sample, absence of reported blinding, and multiple time-point comparisons, these findings should be confirmed in larger, prospectively registered trials.

Keywords

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At a glance

Objective, principal result, and takeaway derived from complete abstract sections without mid-sentence truncation.

Objective

This study evaluated its effect on sensory and motor block characteristics and perioperative hemodynamics during lower-extremity orthopedic surgery.

Key finding

Between-group blood pressure differences did not meet the prespecified p<0.05 threshold.

Clinical takeaway

Intravenous dexmedetomidine was associated with longer sensory and motor block duration and modestly faster block onset, but also with lower perioperative heart rate.

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Scholarly record

Version history

ReceivedJuly 2, 2026
AcceptedSeptember 14, 2026
PublishedSeptember 14, 2026

The Version of Record remains the authoritative article. Corrections, expressions of concern, and retractions are linked here when issued.

Declarations

License

This article is distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0), which permits use, distribution, and reproduction in any medium, provided the original work is properly cited.

Funding

The author declares no funding.

Conflicts of interest

The author declares no conflicts of interest.

Author contributions

Alfonso Gutiérrez was responsible for study conception, methodology, investigation, data collection, data analysis and interpretation, and preparation and revision of the manuscript.

Data availability

The data supporting the findings of this study are not publicly available because they contain participant clinical information. Deidentified data may be available from the corresponding author upon reasonable request, subject to institutional and ethical requirements.

Ethics approval

Approved

Consent for publication

Not Applicable

Trial registration

Not registered

References

Weerink MAS, Struys MMRF, Hannivoort LN, Barends CRM, Absalom AR, Colin P. Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine. Clin Pharmacokinet. 2017;56(8):893-913. doi:10.1007/s40262-017-0507-7. DOI ↗ Scholar ↗
Naaz S, Ozair E. Dexmedetomidine in current anaesthesia practice: a review. J Clin Diagn Res. 2014;8(10):GE01-GE04. doi:10.7860/JCDR/2014/9624.4946. DOI ↗ Scholar ↗
Abdallah FW, Abrishami A, Brull R. The facilitatory effects of intravenous dexmedetomidine on the duration of spinal anesthesia: a systematic review and meta-analysis. Anesth Analg. 2013;117(1):271-278. doi:10.1213/ANE.0b013e318290c566. DOI ↗ Scholar ↗
Kılıç ET, Aydın G. Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation. Libyan J Med. 2018;13(1):1436845. doi:10.1080/19932820.2018.1436845. DOI ↗ Scholar ↗
Sekar EB, Vijayaraghavan U, Sadiqbasha AM. Effect of intravenous dexmedetomidine on spinal anesthesia. Cureus. 2021;13(6):e15708. doi:10.7759/cureus.15708. DOI ↗ Scholar ↗
Thakkar PD, Patel DR, Shah UD, Gupta S, Dudhani R, Mirchandani B. Effect of intravenous dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine: a prospective study. J Popul Ther Clin Pharmacol. 2024;31(2):890-895. doi:10.53555/jptcp.v31i2.4299. DOI ↗ Scholar ↗
Chahal S, Bhalotra AR, Singh R, Dhiman S, Singh S. Effect of intravenous dexmedetomidine on sensory block duration in spinal anesthesia for lower limb surgery: a randomized controlled trial. Braz J Anesthesiol. 2025;75(6):844672. doi:10.1016/j.bjane.2025.844672. DOI ↗ Scholar ↗
Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc (Bayl Univ Med Cent). 2001;14(1):13-21. doi:10.1080/08998280.2001.11927725. DOI ↗ Scholar ↗

How to Cite

Gutierrez A. Intravenous Dexmedetomidine as an Adjunct to Spinal Anesthesia for Lower-Extremity Orthopedic Surgery: A Randomized Controlled Study. Int J Clin Innov. 2026;1(1).

Received July 2, 2026 · Accepted September 14, 2026

Creative Commons Attribution 4.0 International (CC BY 4.0)

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[reference-1] Weerink MAS, Struys MMRF, Hannivoort LN, Barends CRM, Absalom AR, Colin P. Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine. Clin Pharmacokinet. 2017;56(8):893-913. doi:10.1007/s40262-017-0507-7. DOI ↗ Scholar ↗

[reference-2] Naaz S, Ozair E. Dexmedetomidine in current anaesthesia practice: a review. J Clin Diagn Res. 2014;8(10):GE01-GE04. doi:10.7860/JCDR/2014/9624.4946. DOI ↗ Scholar ↗

[reference-3] Abdallah FW, Abrishami A, Brull R. The facilitatory effects of intravenous dexmedetomidine on the duration of spinal anesthesia: a systematic review and meta-analysis. Anesth Analg. 2013;117(1):271-278. doi:10.1213/ANE.0b013e318290c566. DOI ↗ Scholar ↗

[reference-4] Kılıç ET, Aydın G. Effects of dexmedetomidine infusion during spinal anesthesia on hemodynamics and sedation. Libyan J Med. 2018;13(1):1436845. doi:10.1080/19932820.2018.1436845. DOI ↗ Scholar ↗

[reference-5] Sekar EB, Vijayaraghavan U, Sadiqbasha AM. Effect of intravenous dexmedetomidine on spinal anesthesia. Cureus. 2021;13(6):e15708. doi:10.7759/cureus.15708. DOI ↗ Scholar ↗

[reference-6] Thakkar PD, Patel DR, Shah UD, Gupta S, Dudhani R, Mirchandani B. Effect of intravenous dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine: a prospective study. J Popul Ther Clin Pharmacol. 2024;31(2):890-895. doi:10.53555/jptcp.v31i2.4299. DOI ↗ Scholar ↗

[reference-7] Chahal S, Bhalotra AR, Singh R, Dhiman S, Singh S. Effect of intravenous dexmedetomidine on sensory block duration in spinal anesthesia for lower limb surgery: a randomized controlled trial. Braz J Anesthesiol. 2025;75(6):844672. doi:10.1016/j.bjane.2025.844672. DOI ↗ Scholar ↗

[reference-8] Gertler R, Brown HC, Mitchell DH, Silvius EN. Dexmedetomidine: a novel sedative-analgesic agent. Proc (Bayl Univ Med Cent). 2001;14(1):13-21. doi:10.1080/08998280.2001.11927725. DOI ↗ Scholar ↗

Research in context

Abstract

Background

Methods

Results

Conclusions

Keywords

At a glance

Typeset article PDF

Version history

Declarations

License

Funding

Conflicts of interest

Author contributions

Data availability

Ethics approval

Consent for publication

Trial registration

References

How to Cite

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