A randomised controlled trial of dexmedetomidine compared to placebo to reduce pain after spinal fusion surgery

Spinal fusion surgery — an operation to join vertebrae in the spine — is performed for conditions like disc disease, spinal instability, and deformity, but it can cause significant pain in the days afterward. Good pain management after surgery helps patients recover faster and reduces the need for strong opioid painkillers. This trial tests whether dexmedetomidine — a sedative drug with pain-relieving properties sometimes used in intensive care — can reduce pain scores after spinal fusion surgery. You may be eligible if you are 18 or older, are having thoracic or lumbar spinal fusion surgery using a posterior (back of the spine) approach at the Royal Melbourne Hospital, and plan to stay at least one night in hospital. People with significant cardiac conduction problems, severe heart disease, liver cirrhosis, low heart rate or blood pressure before surgery, or a known allergy to dexmedetomidine are not eligible. Participants are randomly assigned to receive dexmedetomidine or a saline placebo infusion during and after surgery, with neither them nor their doctors knowing which is which. Pain scores, opioid use, and side effects are tracked over the following days. If effective, dexmedetomidine could offer a valuable new option in the multimodal approach to post-operative pain management for spinal surgery.