Effect of Dexmedetomidine on Postoperative Pain in Knee Arthroscopic Surgery; a Randomized Controlled Clinical Trial

Document Type : RESEARCH PAPER

Authors

1 Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

2 Departmant of Orthopedic Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

3 Mashhad University of Medical Sciences Mashhad Iran

Abstract

knee surgery. The purpose of this study was to assess the analgesic effects of intra-articular injection of a dexmedetomidine
following knee arthroscopy.
Methods:
 
Forty six patients schadualed for arthroscopic knee surgery under general anaesthesia, were randomly
devided into two groups. Intervention group received 1μg/kg dexmedetomidine (D) and isotonic saline. Control group
received 25ml isotonic saline (P). Analgesic effects were evaluated by measuring pain intensity (VAS scores) and
duration of analgesia.
Results:
 
There was no significant difference between the two groups in terms of age, sex and weight. The mean of
post-operation pain severity in 1, 3, 6,12, and 24 h was significantly lower in the intervention group (D) in comparison
with the control group (P). the mean of the total dose of tramadol consumption was significantly lower in the interven
 
tion
group in comparison with the control group (
 
P<0.001).
Conclusions:
 
Intra-articular injection of dexmedetomidine at the end of arthroscopic knee surgery, alleviates the
patients’ pain; reducing the postoperative need for narcotics as analgesics, and increase the first analgesic request
after operation.

Keywords

References

  1. El-Hamamsy M, Dorgham M. Intra-articular Adjuvant Analgesics Following KneeArthroscopy: Comparison between Dexmedetomidine and Fentanyl. Res J Medicine & Med Sci. 2009; 4(2): 355-60.

  2. Paul S, Bhattacharjee DP, Ghosh S, Dawn S, Chatterjee N. Efficacy of intra-articular dexmedetomidine for postoperative analgesia in arthroscopic knee surgery. Ceylon Med J. 2010; 55(4): 111-15.

  3. Dogan N, Erdem AF, Erman Z, Kizilkaya M. The Effects of Bupivacaine and Neostigmine on Articular Cartilage and Synovium in the Rabbit Knee Joint. J Int Med Res. 2004; 32: 513-9.

  4. Dennis AR, Leeson-Payne CG, Hobbs GJ. A comparison of diclofenac with ketorolac for pain relief after knee arthroscopy. Anesthesia. 1995; 50(10): 904–6. 

  5. Al-Metwalli RR, Mowafi HA, Ismail SA, Siddiqui AK, Al-Ghamdi AM, Shafi MA, et al. Effect of intra-articular dexmedetomidine on postoperative analgesia after arthroscopic knee surgery. Br J Anaesth. 2008;101(3):395-9.

  6. Dahl MR, Dasta JF, Zuelzer W, McSweeney TD. Lidocainelocal anaesthesia for arthroscopic knee surgery. Anesth Analg. 1990; 71: 670-4.

  7. Chirwaa SS, MacLeod BA, Day B. Intra-articular bupivacaine after arthroscopic meniscectomy: a randomized double blind controlled study. Arthroscopy. 1989; 5: 33-5.

  8. Stein C, Comisel K, Haimerl E, Yassouridis A. Analgesic effect of intra-articular morphine after arthroscopic knee surgery. N Engl J Med. 1991;  325:1123-6.

  9. Gentili M, Juhel A, Bonnet F. Peripheral analgesic effect ofintra-articular clonidine. Pain. 1996; 64: 593-6.

  10. Bondok RS, Abd El-Hady AM. Intra-articular magnesiumis effective for postoperative analgesia in arthroscopic kneesurgery. Br J Anaesth. 2006; 97: 389-92.

  11. Varkel V, Volpin G, Ben-David B, Said R, Grimberg B, Simon K, Soudry M.Intraarticular fentanyl compared with morphine for pain relief following arthroscopic knee surgery.Can J Anaesth. 1999;46(9):867-71.

  12. Gerlach AT, Dasta JF. Dexmedetomidine: an updated review. Ann Pharmacother. 2007; 41: 245-52.

  13. Karaaslan D, Peker TT, Alaca A, Ozmen S, Kirdemir P, Yorgancigil H, et al. Comparison of buccal and intramuscular dexmedetomidine premedication for arthroscopic knee surgery. J Clin Anesth. 2006; 18: 589–93.

  14. Gomez-Vazquez ME, Hernandez-Salazar E, Hernandez-Jimenez A, Perez-Sanchez A, Zepeda-Lopez VA, Salazar-Paramo M. Clinical analgesic efficacy and side effects of dexmedetomidine in the early postoperative period after arthroscopic knee surgery. J Clin Anesth. 2007; 19: 576–82.

  15. Ebert TJ, Hall JE, Barney JA, Ulrich TD, Colinco MD. The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology. 2000; 93: 382–94.

  16. Yaksh TL, Reddy SVR. Studies in the primate on analgesic effects associated with intrathecal actions of opiates, alpha2adrenergic agonists and baclofen. Anesthesiology. 1981; 54:451-67.

  17. Butterworth JFV, Strichartz GR. The alpha 2 adrenergic agonists clonidine and gunafacine produce tonic and phasic block of conduction in rat sciatic nerve fibres. Anesth Analg. 1993; 76: 295-301.

  18. Nakamura M, Ferreira SH. Peripheral analgesic action of clonidine: mediation by release of endogenous enkephalin like substances. Eur J Pharmacol. 1988;146: 223-8.

  19. Post C, Archer T, Minor BG. Evidence for cross tolerance to the analgesic effects between morphine and selective alpha 2-adrenergic agonists. J Neural Transm. 1988; 72: 1–9.

  20. Buerkle H, Schäpsmeier M, Bantel C, Marcus MA, Wüsten R, VanAken H. Thermal and mechanical antinociceptive action of spinal vs peripherally administered clonidine in the rat inflamed knee joint model. Br J Anaesth. 1999; 83: 436–41.

  21. Khasar SG, Green PG, Chou B, Levine JD. Peripheral nociceptiveeffects of alpha 2-adrenergic receptor agonists in the rat. Neuroscience.1995; 66: 427–32.

  22. Dye SF, Vaupel GL, Dye CC. Conscious neurosensory mapping ofthe internal structures of the human knee without intraarticular anesthesia. Am J Sports Med. 1998; 26: 773–7.

  23. Breu A, Rosenmeier K, Kujat R, Angele P, Zink W. The cytotoxicity of bupivacaine, ropivacaine, and mepivacaine on human chondrocytes and cartilage.Anesth Analg. 2013;117(2):514-22.

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History

  • Receive Date: 09 January 2014
  • Revise Date: 02 February 2014
  • Accept Date: 01 March 2014

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