Dexmedetomidine as an Intrathecal Adjuvant to Hyperbaric Bupivacaine for Postoperative Analgesia in Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction Surgeries

Tanta University64 enrolled

Overview

This study aimed to evaluate the effect of adding low doses of dexmedetomidine to hyperbaric bupivacaine during spinal anesthesia on post operative analgesia characteristics in Arthroscopic Anterior Cruciate Ligament Reconstruction Surgeries

The anterior cruciate ligament (ACL) is injured frequently during sports participation. Arthroscopic evaluation of patients with acute traumatic hemarthrosis of the knee has repeatedly demonstrated a 60% to 70% incidence of ACL injury. Postoperative pain should be effectively treated because it represents an important component of postoperative recovery. Effective treatment serves to blunt autonomic, somatic, and endocrine reflexes with a resultant potential decrease in perioperative morbidity. Dexmedetomidine is a highly selective α2-adrenergic agonist that has been used for premedication and as an adjunct to general anesthesia. It reduces opioid and inhalational anesthetics requirements.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Dexmedetomidine Intrathecal Adjuvant

Interventions

Hyperbaric bupivacaineDRUG

Patients received the standard spinal anesthesia with 0.5% 3 ml according to the patient hyperbaric bupivacaine only

Dexmedetomidine and Hyperbaric bupivacaineDRUG

Patients received dexmedetomidine 4 μg and 0.5% (3-4 ml according to the patient height) hyperbaric bupivacaine

Eligibility

Sex: ALLMin age: 21 YearsMax age: 50 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Aged from 21 to 50 years. * Both genders. * American society of anesthesiologists (ASA) physical status I and II. * Patients scheduled for arthroscopic anterior cruciate ligament reconstruction surgeries under spinal anesthesia. Exclusion Criteria: * Patient refusal. * Body Mass Index (BMI) more than 40 kg/m2. * Patients who were taking analgesics for chronic pain on opioid therapy or have a history of drug abuse. * Uncooperative patient. * Patients with coagulation disorders. * History of local anesthetics allergy. * Infection at the needle puncture site. * Patients with significant respiratory, cardiac, renal or hepatic disorders

Outcomes

Primary Outcomes

Total morphine consumption

The rescue analgesia was morphine IV bolus of 3 mg with when VAS \> 30. Total morphine consumption in the first 24 hours postoperatively was documented.