Preventive Effects of Dexmedetomidine on Hemodynamic Stability in Patients Undergoing Orthopedic Surgery: A Systematic Review

Introduction: Maintaining hemodynamic stability during orthopedic surgery is crucial to reducing perioperative complications. Dexmedetomidine, an α۲-adrenergic agonist, has been increasingly utilized for its sedative, analgesic, and sympatholytic properties. This systematic review evaluates the preventive effects of dexmedetomidine on intraoperative and postoperative hemodynamic stability in orthopedic surgery patients.Materials and Methods: A systematic review was conducted following PRISMA guidelines. Databases including PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched for randomized controlled trials and observational studies investigating dexmedetomidine’s impact on hemodynamic parameters. Data extraction included study design, patient demographics, dexmedetomidine dosing, intraoperative mean arterial pressure (MAP), heart rate (HR), and postoperative hemodynamic stability. Meta-analysis was performed where applicable.Results: Dexmedetomidine significantly reduced intraoperative MAP fluctuations and heart rate variability compared to controls (p < ۰.۰۰۱). Postoperative hypertension (۸.۷۳% vs. ۲۱.۳۵%; p = ۰.۰۱۴) and tachycardia (۱۰.۲۴% vs. ۲۶.۵۷%; p = ۰.۰۰۸) were also lower in the dexmedetomidine group. Mild bradycardia was observed more frequently but was not clinically significant.Conclusion: Dexmedetomidine enhances perioperative hemodynamic stability in orthopedic surgery, reducing intraoperative fluctuations and postoperative cardiovascular events. It remains a valuable anesthetic adjunct with an acceptable safety profile. Future research should focus on optimal dosing strategies.

کلیدواژه ها:

dexmedetomidine ، Hemodynamic Stability ، Orthopedic Surgery ، perioperative management