Comparison of Dexmedetomedine and Bupivacaine on Hemodynamic Stability and Analgesia in Patients Undergoing Lower ExtremityOrthopedic Surgery Under Spinal Anesthesia

Background: adequate control of acute postoperative pain remains one of the major challenges after surgery. this study aimed to compare the effect of dexmedetomidine with and without bupivacaine on hemodynamic symptoms and pain in patients undergoing lower limb orthopedic surgery with spinal anesthesia. methods: this double-blind clinical trial study was conducted on 30 patients undergoing lower limb orthopedic surgery under spinal anesthesia in peymaniyeh jahrom hospital in 2020. patients were randomly divided into two equal groups, a (15 mg of bupivacaine) and group b (15 mg of bupivacaine plus 5 μg of dexmedetomidine). at 2, 6, 12, and 24 hours after surgery, patients' pain was evaluated using vas. patients' hemodynamic symptoms were recorded before anesthesia, immediately after anesthesia, 15, 30, 45, 60, 90, and 120 minutes during surgery and when entering and leaving recovery. data analysis was done using spss version 21 software and using descriptive (mean, percentage and standard deviation) and inferential (anova, t-test, anova with repeated measures) tests. results:at 45, 30, 60, 90, 120 minutes after anesthesia and outside of recovery, the mean systolic blood pressure in group b was significantly lower than group a (p<0.05). the results of the mann-whitney test showed that the average pain in group b at 6 and 12 hours after the operation was significant (p=.04), so that at 6 hours after the operation, the average pain in group b was less than that of group a, but in 12 hours after the operation, the average pain in group b was higher than the bupivacaine group. conclusion: dexmedetomidine drug is an effective drug in controlling hemodynamics in patients undergoing orthopedic surgery of the lower limb, but no statistically significant difference was seen in the amount of pain between the two groups. it is suggested to use dexmedetomidine in order to control and stabilize hemodynamics in patients undergoing orthopedic surgery.