Chakrabarti D, et al. - In this prospective randomized study including 49 patients undergoing cerebello-pontine angle (CPA) surgeries (25 with dexmedetomidine, 24 without), researchers determined the impacts of dexmedetomidine as an anesthetic adjunct to propofol (total intravenous anesthesia) on anesthetic dose reduction and anesthesia recovery parameters in these subjects. Using propofol (via target controlled infusion, titrated to maintain bispectral index (BIS) between 40 and 60), fentanyl (0.5 μg/kg/hour) and either dexmedetomidine (0.5 μg/kg/hour) or a sham infusion, anesthesia was maintained. As far as anesthesia recovery times were concerned, dexmedetomidine–fentanyl–propofol anesthesia compared favorably with fentanyl–propofol anesthesia during CPA neurosurgical procedures, but lower intraoperative opioid and hypnotic utilization rates were seen with the former. A remarkably lower propofol and fentanyl utilization (as total dose, adjusted for duration of surgery and body weight, and number of extra boluses) was seen in the dexmedetomidine group. A significantly higher incidence of bradycardia was seen with dexmedetomidine, while there was no difference for hypotension, hypertension, and tachycardia.