Effects of Intraoperative Dexmedetomidine on Postoperative Narcotic and Antiemetic Requirements after Acoustic Neuroma Resection

Microsurgical resection of acoustic neuroma is frequently complicated by postoperative pain and nausea. Emerging evidence suggests intravenous dexmedetomidine (Precedex) may reduce postoperative pain and nausea following craniotomy. However, studies in neurosurgical patients have comprised small, heterogenous cohorts of patients undergoing resection of predominantly supratentorial lesions. We performed a retrospective analysis of 48 consecutive patients undergoing craniotomy for acoustic neuroma by a single surgical team, including 10 patients who received dexmedetomidine as an intraoperative anesthetic adjuvant and 38 patients who did not. Baseline demographics, clinical characteristics, operative time, surgical approach and intraoperative hemodynamics were largely similar between the two groups. In multivariate analysis, dexmedetomidine usage was associated with significantly lower narcotic requirements postoperatively. Similarly, dexmedetomidine and age were associated with significantly lower anti-emetic requirements postoperatively. This is the first study to describe the effects of dexmedetomidine on postoperative morbidity in a sizeable cohort of patients undergoing lateral skull base surgery. Furthermore, it is the first study of dexmedetomidine in a neurosurgical patient population stratified by a single pathology. Although subject to limitations inherent to retrospective studies and cohort size, prospective evaluation of these findings is warranted.

No conflict of interest has been declared by the author(s).