Sixty patients undergoing a thoracolumbar spine instrumentation procedure were randomized to receive epidural ropivacaine plus dexmedetomidine (n=30) or epidural ropivacaine alone (n=30) through an epidural catheter. Outcomes of interest included rescue analgesia consumption, time to first rescue analgesia, patient satisfaction scores, time spent in the post-anesthesia care unit (PACU) and in the hospital, visual analogue scale (VAS) pain scores, mean arterial pressure, sedation score, and heart rate. Results revealed significantly lower rescue analgesia in the first 72 hours, longer time to first rescue analgesia, greater patient satisfaction, and shorter stay in the PACU in the combination group compared to the ropivacaine only group. Moreover, VAS pain scores, mean arterial pressure, heart rate, and sedation scores were also significantly in favour of the combination group.