Dexamethasone vs. Dexmedetomidine for ESPB in Pain Management After Knee Arthroplasty

Poznan University of Medical Sciences90 enrolled

Overview

Effect of perineurial dexamethasone and dexmedetomidine on erector spinal plane block duration for knee arthroplasty

This study is proposed to explore the effect of perineurial Dexamethasone and Dexmedetomidine on erector spinal plane block duration for knee surgery. After knee surgery, patients need good analgesia. Peripheral nerve blocks have provided a safe, effective method to control early postoperative pain when symptoms are most severe. Local anaesthesia's much lower toxicity threshold makes it essential for its safety. An effective adjuvant, such as Dexamethasone or Dexmedetomidine, could allow for a higher dilution of local anaesthetics while maintaining and enhancing their analgesic effect. There is considerable research comparing intravenous and perineural dexamethasone and Dexmedetomidine use in orthopaedic surgeries. However, there is a massive lack of research regarding knee surgery and the Erector Spine Plane Block. In this study, investigators compare perineural Dexamethasone and Dexmedetomidine. The investigator aims to find a dexamethasone or dexmedetomidine that covers the need for good pain relief and fast recovery postoperatively.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

QUADRUPLE

Enrollment

Conditions

Knee Osteoarthritis Knee Arthritis Knee Disease Knee Pain Chronic

Interventions

0.9% Sodium Chloride InjectionDRUG

unilateral administration of 20ml of 0,2% ropivacaine + 2ml 0.9% sodium chloride for the erector spine plane block

DexamethasoneDRUG

unilateral administration of 20ml of 0,2% ropivacaine with 4mg Dexamethasone for the erector spine plane block

DexmedetomidineDRUG

unilateral administration of 20ml of 0,2% ropivacaine with 50ug Dexmedetomidine for the erector spine plane block

Eligibility

Sex: ALLMin age: 18 YearsMax age: 100 Years

Medical Language ↔ Plain English

Inclusion Criteria: * patients undergoing primary hip arthroplasty * aged \>18 years and \<100 years * ASA physical status 1, 2 or 3. Exclusion Criteria: * if they refused to participate, * had a history of opioid abuse, * had an infection of the site of needle puncture, * were less than 18 years of age, * were postponed as having ASA 4 or 5, * had an allergy to any of the drugs used in the study, * renal failure (estimated glomerular filtration rate \<15ml/min/1.73m2), * liver failure, * known or suspected coagulopathy, * pre-existing anatomical or neurological disorders in the lower extremities, * intellectual disability with problems in pain evaluation, * severe psychiatric illness.

Locations (1)

Poznan University of Medical Sciences

Poznan, Poznań, Poland

Outcomes

Primary Outcomes

first need of opiate

Time after surgery when the patient needs opiate for the first time

Time frame: 48 hours after surgery