Analgesia efficacy of dexmedetomidine combined with ropivacaine for adductor canal block after total knee arthroplasty

doi:10.3969/j.issn.2095-4344.1289

Abstract

Abstract:

BACKGROUND: Most patients will suffer from severe pain after total knee arthroplasty. How to relieve postoperative pain and reduce postoperative complications is the key to promote early and rapid rehabilitation for patients.

OBJECTIVE: To observe the analgesic effect of dexmedetomidine combined with ropivacaine for adductor canal block in patients undergoing arthroscopic total knee arthroplasty.

METHODS: Forty patients who underwent primary unilateral total knee arthroplasty between October 2017 and September 2018 were randomly divided into two groups (n=20/group), followed by treated by 30 mL 0.375% ropivacaine, and 30 mL 0.375% ropivacaine + 1.5 µg/kg dexmedetomidine, respectively. Both groups received adductor canal block. The study was approved by the Ethics Committee of the Third Affiliated Hospital of Guangzhou Medical University on October 31, 2018, approval number: [2018]170. All patients signed the informed consents, and the surgical department and surgeons had the qualifications for arthroplasty. General anesthesia was conducted, and the operation time and intraoperative blood loss were recorded. The mean arterial pressure, heart rate, oxyhemoglobin saturation, and Ramsay score and numeric pain rating scale score at rest and in activity at 2, 4, 6, 12, 24, and 48 hours after surgery were detected. Opioids consumption, anesthesia related adverse effects, the expression levels of C-reactive protein and interleukin-6 in the serum were detected at 48 hours after surgery.

RESULTS AND CONCLUSION: (1) The Ramsay score at postoperative 2-48 hours in the ropivacaine + dexmedetomidine group was significantly higher than that in the ropivacaine group (P < 0.05). (2) The postoperative numeric pain rating scale score at rest in both groups decreased with time (P < 0.05), and the score at each time point in the ropivacaine + dexmedetomidine group was significantly lower than that in the ropivacaine group (P < 0.05). (3) The postoperative numeric pain rating scale score in activity in both groups decreased with time (P < 0.05), and the score at 12, 24 and 48 hours in the ropivacaine + dexmedetomidine group was significantly lower than that in the ropivacaine group (P < 0.05). (4) The heart rate at postoperative 24 hours in the ropivacaine + dexmedetomidine group was decreased significantly compared with the ropivacaine group (P < 0.05). (5) Six patients in the ropivacaine group and one patient in the ropivacaine + dexmedetomidine group acquired additional use of dolantin (100 mg/times) within postoperative 24 hours (P < 0.05). Two patients in the ropivacaine group and three patients in the ropivacaine + dexmedetomidine group acquired additional use of dolantin once within postoperative 48 hours (P > 0.05). (6) There was one patient who suffered nausea in the ropivacaine group, and two who reported xerostomia. Two patients in the ropivacaine + dexmedetomidine group experienced nausea and xerostomia, and one patient suffered sinus bradycardia (heart rate=49 beats/min). (7) The postoperative expression level of serum C-reactive protein in the ropivacaine + dexmedetomidine group was significantly lower than that in the ropivacaine group (P < 0.05), and there was no significant difference in the interleukin-6 level between two groups (P > 0.05). (8) To conclude, the analgesic effect of dexmedetomidine combined with ropivacaine on adductor canal block after total knee arthroplasty is significantly better than that of ropivacaine alone, and no significant adverse reactions are observed.

Key words:

dexmedetomidine, ropivacaine, adductor canal block, total knee arthroplasty, postoperative analgesia

CLC Number:

R459.9

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R459.9

Tan Zhengling, Chen Junxing, Su Zhiyuan, Liu Xianbao, Lu Xiaoqin, Wang Le.

Analgesia efficacy of dexmedetomidine combined with ropivacaine for adductor canal block after total knee arthroplasty

[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(24): 3798-3804.

Figures/Tables 8

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