Neurosurgical procedures, including craniectomy for tumor resection, epilepsy surgery, aneurysm clipping, and neuroradiological interventions, often present significant challenges in postoperative pain management. Traditional opioid-based analgesia is associated with risks such as respiratory depression, increased intracranial pressure, and interference with neurological assessments. As a result, opioid-free anesthesia strategies have gained attention, with dexmedetomidine (DEX) playing a crucial role. DEX, a highly selective α2-adrenergic agonist, provides sedative, analgesic, and anesthetic effects without causing significant respiratory depression. This review explores the continuous administration of dexmedetomidine in neurosurgical patients, evaluating its impact on hemodynamic stability and its potential to reduce perioperative opioid use while maintaining intraoperative hemodynamic control. The findings suggest that dexmedetomidine offers advantages in postoperative pain management, reduces sympathetic responses, and minimizes opioid-related side effects, ultimately improving patient outcomes. However, further studies are necessary to establish standardized dosing protocols and assess long-term efficacy and safety in neurosurgical populations.
Rahadiyan et al. (Sat,) studied this question.