DOI

10.21007/con.dnp.2026.0137

Faculty Advisor

Dwayne Accardo, DNP, CRNA, FAANA

Document Type

Poster

Publication Date

Spring 4-30-2026

Disciplines

Health and Medical Administration | Investigative Techniques | Medicine and Health Sciences | Nursing | Quality Improvement

Abstract

Purpose/Background 

Spinal anesthesia is widely used in surgical practice because it provides effective anesthesia and analgesia while reducing the need for intravenous anesthesia. Opioids are commonly used as intrathecal adjuvants; however, their use is associated with adverse effects such as pruritus, postoperative nausea and vomiting (PONV), urinary retention, and respiratory depression. Dexmedetomidine, a selective α2-adrenergic agonist, has gained attention as an alternative to opioids due to its sedative and analgesic properties without the opioid side effect profile. This scoping review evaluates current evidence comparing intrathecal Dexmedetomidine and opioids as adjuvants to spinal anesthesia in adult surgical patients.

Methods

A scoping literature review was conducted to compare the associations of positive and negative effects of dexmedetomidine. Ten critically appraised randomized controlled trials, including adult surgical patients (≥18 years) receiving intrathecal anesthesia with either Dexmedetomidine or opioids as adjuvants to local anesthetics, were examined. Extracted data focused on adverse events, perioperative hemodynamics, block characteristics, and postoperative analgesic requirements associated with each medication.

Results 

            Ten randomized controlled trials published between 2014 and 2024 were studied, which supported that Dexmedetomidine had longer sensory and motor block with lower analgesic requirements and adverse side effects. No clinical significance was observed between the groups in hemodynamic parameters, including blood pressure and heart rate. Overall, Dexmedetomidine demonstrated enhanced analgesia with a more favorable side effect profile compared to opioids.

Implications Into Practice

Findings suggest intrathecal Dexmedetomidine is a clinically viable alternative to intrathecal opioids as an adjuvant to spinal anesthesia in adult surgical patients. Implementing an intrathecal multimodal project including Dexmedetomidine could promote multimodal, opioid sparing anesthetic strategies that improve patient outcomes, comfort, and recovery.

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