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

Abstract

BACKGROUND:

Alpha-2-adrenergic agonists have peripheral analgesic effects. We have assessed the potential analgesic effect of dexmedetomidine after intra-articular administration in arthroscopic knee surgery.

METHODS:

Sixty patients undergoing arthroscopic knee surgery were randomly assigned into three groups in a double-blind placebo controlled study. The control group received i.v. and intra-articular saline, the intra-articular group received i.v. saline and intra-articular dexmedetomidine, and the i.v. group received i.v. dexmedetomidine and intra-articular saline. Haemodynamic changes, pain visual analogue scale (VAS), sedation score, the time to first postoperative analgesic request, and the total postoperative analgesic use during the first 24 h were evaluated.

RESULTS:

Dexmedetomidine administration resulted in a significant reduction in pain scores for 6 h after operation in the intra-articular group but only for 1 h in the i.v. group. The time to first postoperative analgesic request was longer in the intra-articular group [312.0 (SD 120.7) min] compared with the control group [71.0 (50.1) min] and the i.v. group [102.1 (54.4) min] (P<0.001). Total diclofenac requirement was significantly lower in the intra-articular group [90.0 (46.2) mg] than in the control group [165.0 (52.2) mg] and in the i.v. group [129.3 (54.3) mg] (P<0.05).

CONCLUSIONS:

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.

• Authors: R R Al-Metwalli, H A Mowafi, S A Ismail, A K Siddiqui, A M Al-Ghamdi, M A Shafi, A-R El-Saleh
• Journal: British journal of anaesthesia (Br J Anaesth) Vol. 101 Issue 3 Pg. 395-9 (Sep 2008) ISSN: 1471-6771 [Electronic] England
• PMID: 18567675 (Publication Type: Journal Article, Randomized Controlled Trial)

Chemical References

• Analgesics, Non-Narcotic
• Dexmedetomidine

Topics

• Adult
• Aged
• Analgesics, Non-Narcotic (administration & dosage)
• Arthroscopy
• Blood Pressure (drug effects)
• Dexmedetomidine (administration & dosage)
• Double-Blind Method
• Female
• Heart Rate (drug effects)
• Humans
• Injections, Intra-Articular
• Injections, Intravenous
• Knee Joint (surgery)
• Male
• Middle Aged
• Pain Measurement (methods)
• Pain, Postoperative (prevention & control)