Dexmedetomidine versus remifentanil in sedation, analgesia, and vital signs in stereotactic brain biopsy: A randomized, single-blind, active-controlled clinical trial.

ObjectiveStereotactic frame-based brain biopsy is a minimally invasive neurosurgical technique. Dexmedetomidine, an alpha-2 adrenergic agonist, is known to decrease heart rate, blood pressure, and stress response. Remifentanil is a short-acting opioid receptor agonist. This study compared dexmedetomidine and remifentanil with respect to sedation quality, hemodynamic alterations, analgesia, and recovery profiles during stereotactic brain biopsy.MethodsA total of 140 American Society of Anesthesiology class II patients (72 males, 68 females) were enrolled in a single-blind controlled trial. Patients were randomly divided into the remifentanil group and the dexmedetomidine group. Intraoperative monitoring included blood pressure, oxygen saturation, heart rate, and the Ramsay sedation scale. The visual analog scale score and the total morphine consumption were measured in the postanesthesia care unit.ResultsRamsay sedation scale scores were significantly higher in the remifentanil group (p < 0.001). Heart rate, systolic blood pressure, and diastolic blood pressure were significantly higher in the dexmedetomidine group (p = 0.012, p < 0.001, and p < 0.001, respectively). Visual analog scale scores and total morphine consumption were significantly lower in the dexmedetomidine group (p < 0.001 and p < 0.001, respectively).ConclusionsThe remifentanil group achieved a deeper level of sedation. The dexmedetomidine group had higher mean hemodynamic parameters. The visual analog scale scores and the dose of consumed morphine in the postanesthesia care unit were lower in the dexmedetomidine group.Clinical trial registration code: IRCT20210415050983N2.