Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial (original) (raw)
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Anesthesiology
BackgroundAn optimal opioid-sparing multimodal analgesic regimen to treat severe pain can enhance recovery after total knee arthroplasty. The hypothesis was that adding five recently described intravenous and regional interventions to multimodal analgesic regimen can further reduce opioid consumption.MethodsIn a double-blinded fashion, 78 patients undergoing elective total knee arthroplasty were randomized to either (1) a control group (n = 39) that received spinal anesthesia with intrathecal morphine, periarticular local anesthesia infiltration, intravenous dexamethasone, and a single injection adductor canal block or (2) a study group (n = 39) that received the same set of analgesic treatments plus five additional interventions: local anesthetic infiltration between the popliteal artery and capsule of the posterior knee, intraoperative intravenous dexmedetomidine and ketamine, and postoperatively, one additional intravenous dexamethasone bolus and two additional adductor canal blo...
BioMed Research International, 2020
Background. Clinical studies on the impact of dexmedetomidine on tourniquet-induced systemic effects have been inconsistent. We investigated the impact of dexmedetomidine on tourniquet-induced systemic effects in total knee arthroplasty. Methods. Eighty patients were randomly assigned to either control (CON) or dexmedetomidine (DEX) group. The DEX group received an intravenous loading dose of 0.5 μg/kg DEX over 10 minutes, followed by a continuous infusion of 0.5 μg/kg/h from 10 minutes before the start of surgery until completion. The CON group received the same calculated volume of normal saline. Pain outcomes and metabolic and coagulative changes after tourniquet application and after tourniquet release were investigated. Results. The frequency of fentanyl administration postoperatively, patient-controlled analgesia (PCA) volume at 24 hours postoperatively, total PCA volume consumed in 48 hours postoperatively, and VAS score for pain at 24 and 48 hours postoperatively were signif...
IOSR Journals , 2019
Spinal anaesthesia is a popular technic adopted but there are some drawbacks linked with spinal anaesthesia, pain at the puncture site, fear of needles,stress factors in operation room, block level mismatch, monitor sounds and recall of the procedure. The importance of sedation is that it offers analgesia, anxiolysis, and amnesia. Dexmeditomidine and propofol for moderate sedation are best during spinal anaesthesia. AIM: The objectives are to compare Intraoperative sedation, Intraoperative hemodynamic parameters , Intraoperative respiratory stability and side effects. METHODOLOGY: Study was approved by institutional medical ethics committee and written informed consent obtained from all patients participating in the study. 150 patients of ASA grade I ,II between 18-60 years age of both sexes undergoing various surgeries under spinal anesthesia.Patients divided into 3 groups containing 50 each according to computer generated random allocation method. Group D recieved Dexmeditomidine.(1mic/kg loading dose over 10 min followed by maintenance of 0.5 mic/kg/hr) ,Group P recieved Propofol 6mg/kg/hr infused over 10 minutes (1mg/kg bolus) followed by 1.5mg/kg/hr and Group C received normal saline. RESULTS: Throughout the infusion process, hemodynamic data, respiratory rate, oxygen saturation, sedation, pain, and side effects were recorded. Postoperative hemodynamic measurements, oxygen saturation, sedation, pain scores were obtained : CONCLUSION: Dexmeditomidine is a safe and attractive drug for sedation in patients undergoing surgeries under spinal anaesthesia