Intranasal Dexmedetomidine for Post-Operative Analgesia in Geriatric Patients Undergoing Lower Limb Orthopedic Surgeries

Abstract

Objective: To evaluate the efficacy of intranasal dexmedetomidine for postoperative analgesia in geriatric patients undergoing lower limb orthopaedic surgeries, with postoperative pain scores as primary outcome and haemodynamic stability and sedation as secondary outcome during the first 24 h. Methods: This prospective, randomized, double-blinded clinical study was conducted with total of 100 patients aged 65 y and above undergoing lower limb orthopaedic surgeries under subarachnoid blockade; they were randomly allocated into two groups. The dexmedetomidine group received intranasal dexmedetomidine 0.6 µg/kg diluted to 1 ml, while the control group received 1 ml of normal saline. Postoperative pain was assessed using the VAS, sedation using the mRASS, and vital parameters were monitored for up to 24 h postoperatively and adverse events were also recorded. Results: Baseline demographic characteristics were comparable. The dexmedetomidine group demonstrated significantly lower VAS scores at 45 min, 1 hour, and 4 h. Haemodynamic parameters were comparable between groups. Sedation assessment showed significantly lower mRASS scores in Group D during the early postoperative period. Conclusion: Intranasal dexmedetomidine administered at a dose of 0.6 µg/kg appears to provide effective early postoperative analgesia with mild postoperative sedation and stable haemodynamic and respiratory profiles in geriatric patients undergoing lower limb orthopaedic surgeries and may serve as a safe and non-invasive analgesic adjunct.