How does intraarticular dexmedetomidine injection effect articular cartilage and synovium? An animal study

Abstract

Background Intraarticular injections are widely used to provide pain relief after arthroscopic procedures and minimize the use of opioids. Dexmedetomidine has been proven to potentiate pain relief and postpone the demand for the first analgesic drug when it is used intraarticularly following arthroscopic knee procedures. However, the effects of dexmedetomidine on articular structures have not yet been evaluated. Our aim was to determine the effects of intraarticular dexmedetomidine injection on articular structures such as cartilage and synovium. Design Animal study. Methods Twenty adult rats (Sprague-Dawley) were enrolled in the study. Following appropriate aseptic and anesthetic conditions, dexmedetomidine (100 mcg/ml) (0.25 ml) was injected into the right knee joint (the study group) and normal saline solution (0.25 ml) into the left knee joint (the control group) of the rats. Four rats were sacrificed from each group on days 1, 2, 7, 14, and 21, and knee joint samples were obtained. Histologists evaluated the articular and periarticular regions and the synovium using histological sections, and a five-point scale was used to grade the inflammatory changes in a blinded manner. Results The groups were found to be similar in terms of median congestion scores, edema and inflammation scores, subintimal fibrosis, neutrophil activation and cartilage structure at each of the time intervals. Conclusion In our placebo-controlled, in vivo trial, the intraarticular use of dexmedetomidine seemed to be safe with respect to the studied histopathological parameters. However, complementary studies investigating the histopathological effects, analgesic dosage and adverse effects of dexmedetomidine on damaged articular structure models are needed.

Concentrations of dexmedetomidine and effect on biomarkers of cartilage toxicity following intra-articular administration in horses

“…In rats, administration of 25 ug of dexmedetomidine into the knee joint did not appear to have detrimental effects on histopathological parameters. 15 Although there are no in vivo studies describing the effects of α 2 -adrenergic agonists on joint structures following administration to horses, the effects of dexmedetomidine on equine chondrocytes in vitro have been described. 16 Mancini and colleagues 16 reported that exposure to dexmedetomidine impaired mitochondrial and lysosomal functions, altered cell membrane integrity, and induced late apoptosis and necrosis in the joint.…”

The Amalgamation of Risk Assessment Using Quality by Design Principles and Prediction of Regression Models in the Development of Dexmedetomidine-loaded Lipospheres for Intra-articular Administration

“…7 DEX is receiving lot of attention as drug of choice. 8 Al-Metwalli and colleagues evaluated the prospective pain relief influence of DEX when given through intra articular route and concluded that DEX enhanced post-operative analgesia. 9 The drugs used in treatment of arthritis are usually given by oral, subcutaneous, and intramuscular routes.…”

A Comparative Evaluation of Intra-articular Bupivacaine vs Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgeries

“…Action potentials can move through axons, dendrites, and muscle tissue owing to sodium channels that are membrane proteins. One large alpha subunit and one or two small beta subunits make up sodium channels in various tissues [13]. All three local anaesthetic binding and ion conduction sites have four domains with six alphahelical membrane-spanning segments.…”