Retrospective Analysis of Perioperative Dexmedetomidine Use in Retina Surgeries: Impact on Postanesthesia Care

Background and objective: Dexmedetomidine (Precedex (R)) has been linked to depressive hemodynamic effects and increased length of stay in the post-anesthesia care unit (PACU) when used in ambulatory phacoemulsification procedures. We aimed to determine the prevalence and impact of dexmedetomidine use during ambulatory vitreoretinal procedures. Patients and methods: This retrospective cohort study involved 9,666 adult vitrectomies. Cases were divided into groups by anesthesia type: general anesthesia (GA) and monitored anesthesia care (MAC). For each group, various factors were compared between those who did and did not receive dexmedetomidine. Chi-squared and t tests were used for comparisons. Results: Changes in mean arterial pressure in the MAC group were -1.69 +/- 0.23 mmHg for no dexmedetomidine patients and -6.31 +/- 0.39 mmHg for dexmedetomidine patients (P < 0.01). In the GA group, mean arterial pressure was -6.1 +/- 0.35 mmHg for no dexmedetomidine patients and -11.18 +/- 0.88 mmHg for dexmedetomidine patients (P < 0.01). PACU Phase II time in the MAC group was 36.93 +/- 0.37 minutes and 40.67 +/- 0.86 minutes for no dexmedetomidine and dexmedetomidine patients, respectively (P < 0.01). In the GA group, PACU Phase II time was 58.63 +/- 0.95 minutes and 65.19 +/- 2.38 minutes for no dexmedetomidine and dexmedetomidine patients, respectively (P < 0.01). Conclusions: Dexmedetomidine use in vitrectomies was associated with significant PACU delays. These delays may stem from adverse hemodynamic effects.