Efficacy of intra-articular dexmedetomidine for postoperative analgesia in arthroscopic knee surgery done under spinal anesthesia

Muneer, Khawer; Khurshid, Hina; Naqashbandi, Javid Iqbal

doi:10.4103/0970-5333.186464

Cited by 2 publications

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“…Another support to our results are two different studies evaluated the efficacy of IA dexmedetomidine and they concluded that IA dexmedetomidine in a dose of 1 μg/kg alleviates postoperative pain, reduces the need for narcotics as analgesics and increases the time to first analgesic request. [1920]…”

Section: Discussionmentioning

confidence: 99%

Intra-articular morphine versus dexmedetomedine for knee arthroscopy under local anesthesia

2019

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Background: Knee arthroscopy has both diagnostic and therapeutic applications which can be performed under general, regional, or local anesthesia. Morphine is used as an additive to local anesthetics. Dexmedetomedine, the highly selective alpha-2 (α2)-adrenoceptor agonist with the sedative and analgesic effect can be used also to augment local anesthetic effect. Patients and Methods: Sixty patients submitted for elective knee arthroscopy whose age between 25 and 45 years, of either sex, the American society of anethesiologists physical status Classes I and II at a university hospital were enrolled in this study. Patients were classified into two groups. Morphine Group (M) ( n = 30): Patients received 20 ml of 0.5% bupivacaine plus 5 ml of 0.2% lidocaine with epinephrine 1:200,000 plus 1 mg morphine. Dexmedetomedine Group (D) ( n = 30): Patients received 20 ml of 0.5% bupivacaine plus 5 ml of 0.2% lidocaine with epinephrine 1:200,000 plus 1 μg/kg dexmedetomedine. Results: Demographic data of patients showed no significant difference among the studied groups. Heart rate (HR) was significantly lower in (D) Group compared to that of (M) Group 5 min from the start of procedure to immediately postoperatively. Moreover, (D) Group showed a significant decrease in HR 10 min up to 35 min intraoperatively compared to the basal value. Furthermore, mean arterial blood pressure (MBP) was significantly lower in (D) Group compared to that of (M) Group 15 min from the start of surgery up to 1 h postoperatively. Furthermore, (D) Group showed a significant decrease in MBP 15 min intraoperative up to 2 h postoperatively compared to the basal value. While there was no significant difference in (visual analogue score [VAS], onset and total consumption of ketorolac, surgeon and patients’ satisfaction, side effects in (D) Group compared to (M) Group, respectively. Conclusion: Addition of either morphine or dexmedetomidine to bupivacaine intraarticularly improved both intraoperative anesthesia and postoperative analgesia with minimal side effects or complications in knee arthroscopy, with superiority of dexmedetomidine compared to morphine on hemodynamic stability.

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Section: Discussionmentioning

confidence: 99%

Intra-articular morphine versus dexmedetomedine for knee arthroscopy under local anesthesia

2019

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“A Comparative Evaluation of Effect of Intra Articular Fentanyl Versus Dexmedetomidine as Adjuvant to Ropivacaine on Post Operative Pain in Knee Arthroscopic Surgeries”

Noorani

Rastogi

Situ

et al. 2022

Global Journal for Research Analysis

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Background: Knee arthroscopy involves good repair of knee ligaments and menisci with minimal injuries but with variable degree of post operative pain. This pain can be minimal in some but can be very distressing in others. This study aims at evaluating effect of intra articular fentanyl versus dexmedetomidine as adjuvant to ropivacaine on post operative pain in knee arthroscopic surgeries. Ninety patients of ASA Class I Materials and Methods: /II, aged 20–60 years posted for arthroscopic knee surgery were randomly divided into Group R (control group),Group RF(fentanyl) and Group RD (dexmedetomidine) with 30 patients in each group. Anaesthetic technique used was spinal anaesthesia in all patients. Group I patients received Ropivacaine 0.75% 22 ml , group II received Ropivacaine 0.75% 20 ml +Fentanyl 1mcg/kg and Group III received 1 µg/kg dexmedetomidine diluted to 20 ml Ropivacaine 0.75% via intra-articular route at end of procedure. VAS score for 24 h, time to rst rescue analgesia and total dose of analgesic required in each group was evaluated. Results: VAS scores were signicantly lower in Group III, time to rst analgesic requirement was highest in group III (412.2±34.9mins) and lowest in group I (280.4±18.8mins), P value 0.002. Total dose of analgesic used in Group III (166.667±47.946 mg) patients was signicantly lesser compared to patients in Group I (273.33±44.978 mg) and group II (183.33±46.113 mg), P value 0.0226. Intra-articular dexmedetomidine as adjuvant t Conclusion: o 0.75% ropivacaine is effective in providing prolonged postoperative analgesia and decreases total analgesic requirements without any signicant side effects after arthroscopic knee procedures.

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Efficacy of intra-articular dexmedetomidine for postoperative analgesia in arthroscopic knee surgery done under spinal anesthesia

Cited by 2 publications

References 0 publications

Intra-articular morphine versus dexmedetomedine for knee arthroscopy under local anesthesia

Intra-articular morphine versus dexmedetomedine for knee arthroscopy under local anesthesia

“A Comparative Evaluation of Effect of Intra Articular Fentanyl Versus Dexmedetomidine as Adjuvant to Ropivacaine on Post Operative Pain in Knee Arthroscopic Surgeries”

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