Effect of postoperative analgesia with the combination of dexmedetomidine and butorphanol after spinal posterior surgery: a randomized controlled trial.

BACKGROUND: To evaluate the safety and efficacy of dexmedetomidine combined with butorphanol for postoperative analgesia in patients undergoing posterior spinal surgery. METHODS: 60 Patients undergoing posterior spinal surgery were randomly divided into two groups: the butorphanol 0.125 mg/kg group (group B, n = 30) and the butorphanol 0.125 mg/kg combined with dexmedetomidine 0.1 µg/kg/h group (group DB, n = 30). The postoperative pain, degree of sedation, adverse drug reactions, and total satisfaction rate of the two groups were recorded. RESULTS: A total of 60 patients completed the study (Group B, n = 30; DB group, n = 30), and the baseline characteristics (age, gender, BMI) of the two groups were essentially similar (p > 0.05). The Visual Analog Scale (VAS) scores at rest and during exercise in group DB were significantly lower than those in group B (P < 0.05). The number of pressings in group B was significantly higher than that in group DB (P < 0.05). The Ramsay Sedation Score in group DB was higher than that in group B at T1, T2 (P < 0.05). Compared with group B, the incidence of nausea was significantly decreased in group DB (P < 0.05). Compared with group B, the total satisfaction rate of patients in group DB was significantly higher (P < 0.05). CONCLUSION: Dexmedetomidine can enhance the analgesic effect of butorphanol after posterior spinal surgery. TRIAL REGISTRATION: The study protocol was approved by the hospital ethics committee at Zigong Hospital of Traditional Chinese Medicine, China, and the trial was registered at the Chinese Clinical Trial Registry (Registration Number: ChiCTR2400093015; Date: 27th, Nov, 2024). It was conducted from December 2024 to June 2025.