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Ismail EA, Sayed JA, Bakri MH, et al. Comparison of intrathecal versus intra-articular dexmedetomidine as an adjuvant to bupivacaine on postoperative pain following knee arthroscopy: a randomized clinical trial. Korean J Pain. 2017;30(2):134-141doi: 10.3344/kjp.2017.30.2.134.
Ismail, E. A., Sayed, J. A., Bakri, M. H., & Mahfouz, R. Z. (2017). Comparison of intrathecal versus intra-articular dexmedetomidine as an adjuvant to bupivacaine on postoperative pain following knee arthroscopy: a randomized clinical trial. The Korean journal of pain, 30(2), 134-141. https://doi.org/10.3344/kjp.2017.30.2.134
Ismail, Eman A, et al. "Comparison of intrathecal versus intra-articular dexmedetomidine as an adjuvant to bupivacaine on postoperative pain following knee arthroscopy: a randomized clinical trial." The Korean journal of pain vol. 30,2 (2017): 134-141. doi: https://doi.org/10.3344/kjp.2017.30.2.134
Ismail EA, Sayed JA, Bakri MH, Mahfouz RZ. Comparison of intrathecal versus intra-articular dexmedetomidine as an adjuvant to bupivacaine on postoperative pain following knee arthroscopy: a randomized clinical trial. Korean J Pain. 2017 Apr;30(2):134-141. doi: 10.3344/kjp.2017.30.2.134. Epub 2017 Mar 31. PMID: 28416997; PMCID: PMC5392657.
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Korean J Pain. 2017 Apr;30(2):134-141. doi: 10.3344/kjp.2017.30.2.134. Epub 2017 Mar 31.

Comparison of intrathecal versus intra-articular dexmedetomidine as an adjuvant to bupivacaine on postoperative pain following knee arthroscopy: a randomized clinical trial.

The Korean journal of pain

Eman A Ismail, Jehan A Sayed, Mohamed H Bakri, Reda Z Mahfouz

Affiliations

  1. Department of Anesthesia, Faculty of Medicine, Assiut University, Assiut, Egypt.
  2. Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Shebin Elkom, Egypt.

PMID: 28416997 PMCID: PMC5392657 DOI: 10.3344/kjp.2017.30.2.134

Abstract

BACKGROUND: Postoperative pain is a common, distressing symptom following arthroscopic knee surgery. The aim of this study was to compare the potential analgesic effect of dexmedetomidine after intrathecal versus intra-articular administration following arthroscopic knee surgery.

METHODS: Ninety patients undergoing unilateral elective arthroscopic knee surgery were randomly assigned into three groups in a double-blind placebo controlled study. The intrathecal dexmedetomidine group (IT) received an intrathecal block with intrathecal dexmedetomidine, the intra-articular group (IA) received an intrathecal block and intra-articular dexmedetomidine, and the control group received an intrathecal block and intra-articular saline. The primary outcome of our study was postoperative pain as assessed by the visual analogue scale of pain (VAS). Secondary outcomes included the effect of dexmedetomidine on total postoperative analgesic use and time to the first analgesic request, hemodynamics, sedation, postoperative nausea and vomiting, patient satisfaction, and postoperative C-reactive protein (CRP) levels.

RESULTS: Dexmedetomidine administration decreased pain scores for 4 h in both the intrathecal and intra-articular groups, compared to only 2 h in the control patient group. Furthermore, there was a significant reduction in pain scores for 6 h in the intra-articular group. The time to the first postoperative analgesia request was longer in the intra-articular group compared to the intrathecal and control groups. The total meperidine requirement was significantly lower in the intra-articular and intrathecal groups than in the control group.

CONCLUSIONS: Both intrathecal and intra-articular dexmedetomidine enhanced postoperative analgesia after arthroscopic knee surgery. Less total meperidine was required with intra-articular administration to extend postoperative analgesia to 6 h with hemodynamic stability.

Keywords: Arthroscopic knee surgery; Bupivacaine; Dexmedetomidine; Intra-articular; Intrathecal; Postoperative analgesia

Conflict of interest statement

CONFLICT OF INTEREST: The authors have no conflicts of interest

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