Anesthetic Management and Role of Dexmedetomidine During Intraoperative Wake Up Test in Juvenile Idiopathic Scoliosis Correction Surgery: A Case Report

Although neurophysiologic monitoring has been continuously developing, a wake-up test is still regarded as gold standard to detect intraoperative motor dysfunction for scoliosis correction surgery. When the wake-up test is being performed, a calm and co-operative patient is truly required. Anesthesia for the wake-up test is one of the greatest challenges for anesthesiologists. One of the anesthesia for the test includes dexmedetomidine. Dexmedetomidine has sedative, analgesic and sympatholytic properties, suitable for the wake-up test procedures. This report aims to demonstrate results of dexmedetomidine to detect the intraoperative motor dysfunction for the scoliosis correction surgery during the performed wake up test. This patient was 11 years old. She was diagnosed juvenile idiopathic scoliosis with the Cobb’s angle 55 degrees. She was scheduled for posterior fusion scoliosis correction with the intraoperative wake-up test. After the surgeon team requested the wake-up test, desflurane was discontinued, but dexmedetomidine was continued with the infusion. The test took only eight minutes before the patient’s awakening with satisfying condition. The girl was perfectly co-operative without any postoperative recalls. During the wake-up test, dexmedetomidine was suggested as a kind of pertinent anesthetic considerations. Its properties were of analgesic, sedative, sympatholytic, and neuro-protective properties