Study Comparing Opioid-Free Anesthesia Using Dexmedetomidine Versus Opioid-Based Anesthesia With Fentanyl for Surgical Correction of Adolescent Idiopathic Scoliosis

What this Trial Is About

This research aims to evaluate opioid-free anesthesia OFA compared to opioid-based anesthesia in adolescents with idiopathic scoliosis undergoing spinal surgery. OFA uses a combination of non-opioid medications to reduce opioid exposure during surgery, potentially improving recovery and minimizing harm. The study specifically investigates the use of dexmedetomidine DEX, a non-opioid drug with pain-relieving and calming effects, which has not been previously studied for its analgesic impact in spinal surgery under general anesthesia. Participants will be randomly assigned to one of two groups the opioid-free group receiving dexmedetomidine with a loading dose of 1 gkg followed by an infusion of 0.5 gkgh, and the opioid-based group receiving fentanyl with the same dosing schedule. Both groups will receive additional anesthetic care including propofol infusion, magnesium sulfate, tranexamic acid, and other standard measures for surgical preparation and monitoring. The study includes careful intraoperative management and a wake-up test to assess neurological function during surgery. During the study, participants will be closely monitored with continuous heart rate and blood pressure measurements, surgical field bleeding assessments, and surgeon satisfaction ratings. Postoperative recovery will be evaluated using pain scales and sedation scores, with rescue analgesia available as needed. The study will also track complications such as nausea, shivering, and respiratory issues. Overall participation includes preoperative preparation, intraoperative monitoring, and postoperative care and observation, lasting throughout the surgery and immediate recovery period.

Opioid-Free Anesthesia Versus Opioid Based Anesthesia For Adolescent Idiopathic Scoliosis