Effect of intra-articular dexmedetomidine on postoperative analgesia after arthroscopic knee surgery

Al-Metwalli, Roshdy; Mowafi, Hany A.; Ismail, Salah A.; Siddiqui, Ahsan Khaliq; Alghamdi, Ali A.; Shafi, Mohamed; El-Saleh, Abdul-Rahman

doi:10.1093/bja/aen184

Cited by 109 publications

(88 citation statements)

References 18 publications

(12 reference statements)

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“…Al-Metwalli et al compared three groups using intra-articular dexmedetomidine, intravenous dexmedetomidine and placebo and concluded that intra-articular dexmedetomidine in a dose of 1 µg /kg enhanced postoperative pain relief and also reduced the need for postoperative analgesia and prolonged the time to first analgesic request. [9] These results are in agreement with our study. Our study was supported by the study by Das et al Das et al found that intra-articular levobupivacaine increases the duration of analgesia and decreases the need for rescue analgesic in first postoperative 24 hrs.…”

Section: Resultssupporting

confidence: 94%

Knee Arthroplasty Surgery: Comparison of Intra-Articular Levobupivacaine and Dexmedetomidine with Ropivacaine and Dexmedetomidine for Post Operative Pain Management

Dhar¹,

Mohanty²,

Routray³

2017

AIMDR

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Background: Local anaesthetics in intra-articular route are commonly used for the management of pain after arthroscopic knee surgery. Dexmedetomidine prolongs the duration of commonly used local anesthetics. In this study, analgesic effect of intra-articular administration of levobupivacaine and dexmedetomidine was compared with ropivacaine and dexmedetomidine in arthroscopic knee surgery. Methods: 80 patients, aged between 20 to 60 years of ASA I and II posted for knee arthroscopy were divided into two equal groups (n = 40) in a randomized double blind study. Patients in Group LD received 10 ml of 0.5% levobupivacaine and 1 mcg/kg dexmedetomidine and Group RD received 10 ml of 0.75% ropivacaine and 1 mcg/kg of dexmedetomidine through intra-articular route at the end of the surgery. In the post-operative period, pain intensity was assessed by visual analogue scale(VAS) VAS score was recorded at 1 st , 5 th , 8 th , 12 th and 18 th post-operative hours. Duration of analgesia, total rescue analgesic requirement in first 18 hours and any side effects were recorded. Results: Group LD showed significantly longer duration of postoperative analgesia and lesser rescue analgesic requirement compared to group RD. Group RD had higher mean VAS score at 5 th and 12 th post-operative hours compare to group LD. Conclusion: Intra-articular levobupivacaine and dexmedetomidine combine provides better postoperative pain relief by increasing duration of the analgesia, and decreasing the need of rescue analgesic compared to intra-articular ropivacaine and dexmedetomidine.

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Section: Resultssupporting

confidence: 94%

Knee Arthroplasty Surgery: Comparison of Intra-Articular Levobupivacaine and Dexmedetomidine with Ropivacaine and Dexmedetomidine for Post Operative Pain Management

Dhar¹,

Mohanty²,

Routray³

2017

AIMDR

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“…Intraarticular dexmedetomidine in patients undergoing arthroscopic knee surgery improves the quality and duration of postoperative analgesia [29,30].…”

Section: Intraarticular Usementioning

confidence: 99%

Dexmedetomidine in Current Anaesthesia Practice- A Review

NAAz

Ozair

2014

JCDR

122

124

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“…Peripheral nerve blocks or central blocks [6,7], and not long ago, intra-articular injection of various local anesthetic agents has become popular in clinical practice [2]. Drugs such as ketorolac, α2-agonists [8], opioids [3,9], and local anesthetics [10,11] have been tried to interrupt the pain pathway. Usage of these drugs in combination, called as the multimodal approach, is usually sufficient for providing analgesia in the initial post-operative period [12].…”

Section: Introductionmentioning

confidence: 99%

“…Intra-articular route of drug administration is an example for the management of pain after joint surgery utilizing the peripheral receptors [3]. Different authors in their previous studies with intraarticular ropivacaine [1,15], fentanyl [16], dexmedetomidine [11], levobupivacaine, and morphine [17] proved their efficacy in providing post-operative analgesia.…”

Section: Introductionmentioning

confidence: 99%

A Comparison Between Intra-Articular 0.2% Ropivacaine and 0.25% Bupivacaine for Post-Operative Analgesia Following Day-Care Arthroscopic Knee Surgeries

Kamath

Kaminuath

2018

Asian J Pharm Clin Res

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Objectives:The objective is to compare the effectiveness of intra-articular injection of ropivacaine and bupivacaine in providing pain relief after arthroscopic knee surgery. Methods:A total of 60 patients of both genders aged 20-60 years, the American Society of Anesthesiologists physical Status I and II, undergoing day-care arthroscopic knee surgery under spinal anesthesia, were assigned into two groups randomly. Group 1 received 10 ml of 0.2% ropivacaine, while Group 2 received 10 ml of 0.25% bupivacaine intra-articularly at the end of the procedure. Pain was assessed for 24 h postoperatively using visual analog scale (VAS) and diclofenac sodium given as rescue analgesia when VAS >3. Time of first analgesic request and total rescue analgesic were noted and compared. Statistical analysis used: Students unpaired t-test and Chi-square test and Mann-Whitney test "Z" value wherever appropriate. A p<0.05 was considered statistically significant. Results:Based on comparable demographic profiles, time for the requirement of first post-operative rescue analgesia (262.43±57.13 vs. 256.30±44.4) min and total mean rescue analgesic requirement was 152.50±57.367 vs. 142.50±41.07 mg in Groups 1 and 2, respectively. Group 1 showed slightly prolonged duration of analgesia, but total analgesic requirement was more than Group 2. However, comparing the duration of analgesia and total analgesic requirement showed no statistically significant difference between the groups (p>0.05). Conclusion:Both ropivacaine and bupivacaine injected intra-articularly have similar efficacy statistically in relieving post-operative pain in day-care arthroscopic knee surgery.

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Effect of intra-articular dexmedetomidine on postoperative analgesia after arthroscopic knee surgery

Abstract: Intra-articular dexmedetomidine enhanced postoperative analgesia after arthroscopic knee surgery, with an increased time to first analgesic request and a decreased need for postoperative analgesia.

Cited by 109 publications

References 18 publications

Knee Arthroplasty Surgery: Comparison of Intra-Articular Levobupivacaine and Dexmedetomidine with Ropivacaine and Dexmedetomidine for Post Operative Pain Management

Knee Arthroplasty Surgery: Comparison of Intra-Articular Levobupivacaine and Dexmedetomidine with Ropivacaine and Dexmedetomidine for Post Operative Pain Management

Dexmedetomidine in Current Anaesthesia Practice- A Review

A Comparison Between Intra-Articular 0.2% Ropivacaine and 0.25% Bupivacaine for Post-Operative Analgesia Following Day-Care Arthroscopic Knee Surgeries

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