Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty

Abstract

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Effects of Ultrasound-Guided Thoracic Paravertebral Nerve Block Combined with Perineural or IV Dexmedetomidine on Acute and Chronic Pain After Thoracoscopic Resection of Lung Lesions: A Double-Blind Randomized Trial

“…It was previously summarized in our review. 43 (1) Peripheral level: perineural dexmedetomidine can maintain the hyperpolarized state of cells by inhibiting the activation of I h current (a non-inactivating, inwardly rectifying current carried by both Na + and K + ions, which is also called the pacemaker current because it is believed to play a significant role in cell excitability) and activates α 2 -adrenoceptor in peripheral blood vessels, constricting blood vessels around the injection site; 20,44 (2) Spinal cord level: dexmedetomidine inhibits the release of excitatory neurotransmitters such as glutamate and substance P in the spinal; 45 (3) Supraspinal level: dexmedetomidine may have a certain amount of systemic absorption and inhibit the descending noradrenergic pathway in the medulla or reduce sympathetic nerve signals, thereby partly achieving its analgesic effect from the central level. 46 Due to this systemic absorption, perineural dexmedetomidine may have similar effects as IV administration.…”