A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty
Background: Epidural analgesia is still the preferred method of postoperative analgesia for total knee arthroplasty in many countries. Dexmedetomidine is a new alpha-2 agonist which had many beneficial effects when administered epidurally. The aim of study was to provide effective postoperative anal...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Taylor & Francis Group
2016-07-01
|
| Series: | Egyptian Journal of Anaesthesia |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1110184916000350 |
| _version_ | 1818155556666343424 |
|---|---|
| author | Ashraf M. Eskandr Ayman M. Ebeid |
| author_facet | Ashraf M. Eskandr Ayman M. Ebeid |
| author_sort | Ashraf M. Eskandr |
| collection | DOAJ |
| description | Background: Epidural analgesia is still the preferred method of postoperative analgesia for total knee arthroplasty in many countries. Dexmedetomidine is a new alpha-2 agonist which had many beneficial effects when administered epidurally. The aim of study was to provide effective postoperative analgesia with hemodynamic stability through reduction of the amount of epidural local anesthetic by adding dexmedetomidine.
Methods: 75 patients, 50–70 years old, ASA physical status I–III undergoing total knee arthroplasty were randomly divided into three equal groups, group I received 0.125% bupivacaine 5 ml/h for postoperative analgesia, group II received 4 ml of a mixture of bupivacaine 0.125% and dexmedetomidine 0.2 μg/kg/h and group III received 3 ml of a mixture of bupivacaine 0.125% and dexmedetomidine 0.2 μg/kg/h. Postoperative pain were scored by visual analog scale (VAS), sedation score, postoperative nalbuphine consumption and hemodynamic parameters were recorded every 4 h for 48 h postoperatively.
Results: The demographic data were comparable in all groups. VAS (visual analog scale) of pain showed a significant reduction between the two groups II, III and group I with insignificant difference between groups II and III at both rest and movement. The mean of nalbuphine consumption during the study period was significantly reduced in group II, III than in group I with insignificant difference between groups II and III. Sedation scores were significantly higher in groups II and III compared to group I. Heart rate was more reduced in groups II and III than in group I with insignificant difference between the groups. The mean arterial blood pressure was significantly reduced in group I than groups II and III from hour 8 till the end of the study.
Conclusion: Dexmedetomidine is an effective adjuvant to epidural bupivacaine for postoperative analgesia after total knee arthroplasty through reducing the amount of local anesthetic. |
| first_indexed | 2024-12-11T14:44:17Z |
| format | Article |
| id | doaj.art-0f0f576ed55b46ef8690886ef6ba3f19 |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-12-11T14:44:17Z |
| publishDate | 2016-07-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-0f0f576ed55b46ef8690886ef6ba3f192022-12-22T01:01:45ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492016-07-0132336536910.1016/j.egja.2016.01.003A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplastyAshraf M. Eskandr0Ayman M. Ebeid1Department of Anaesthesia and Surgical Intensive Care, Faculty of Medicine, Menoufiya University, Shebeen Elkoom, EgyptDepartment of Orthopaedic Surgery, Faculty of Medicine, Menoufiya University, Shebeen Elkoom, EgyptBackground: Epidural analgesia is still the preferred method of postoperative analgesia for total knee arthroplasty in many countries. Dexmedetomidine is a new alpha-2 agonist which had many beneficial effects when administered epidurally. The aim of study was to provide effective postoperative analgesia with hemodynamic stability through reduction of the amount of epidural local anesthetic by adding dexmedetomidine. Methods: 75 patients, 50–70 years old, ASA physical status I–III undergoing total knee arthroplasty were randomly divided into three equal groups, group I received 0.125% bupivacaine 5 ml/h for postoperative analgesia, group II received 4 ml of a mixture of bupivacaine 0.125% and dexmedetomidine 0.2 μg/kg/h and group III received 3 ml of a mixture of bupivacaine 0.125% and dexmedetomidine 0.2 μg/kg/h. Postoperative pain were scored by visual analog scale (VAS), sedation score, postoperative nalbuphine consumption and hemodynamic parameters were recorded every 4 h for 48 h postoperatively. Results: The demographic data were comparable in all groups. VAS (visual analog scale) of pain showed a significant reduction between the two groups II, III and group I with insignificant difference between groups II and III at both rest and movement. The mean of nalbuphine consumption during the study period was significantly reduced in group II, III than in group I with insignificant difference between groups II and III. Sedation scores were significantly higher in groups II and III compared to group I. Heart rate was more reduced in groups II and III than in group I with insignificant difference between the groups. The mean arterial blood pressure was significantly reduced in group I than groups II and III from hour 8 till the end of the study. Conclusion: Dexmedetomidine is an effective adjuvant to epidural bupivacaine for postoperative analgesia after total knee arthroplasty through reducing the amount of local anesthetic.http://www.sciencedirect.com/science/article/pii/S1110184916000350BupivacaineDexmedetomidineEpidural analgesiaKnee arthroplasty |
| spellingShingle | Ashraf M. Eskandr Ayman M. Ebeid A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty Egyptian Journal of Anaesthesia Bupivacaine Dexmedetomidine Epidural analgesia Knee arthroplasty |
| title | A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty |
| title_full | A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty |
| title_fullStr | A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty |
| title_full_unstemmed | A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty |
| title_short | A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty |
| title_sort | dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty |
| topic | Bupivacaine Dexmedetomidine Epidural analgesia Knee arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S1110184916000350 |
| work_keys_str_mv | AT ashrafmeskandr adosereductionstudyoflocalanestheticwithadditionofdexmedetomidineonpostoperativeepiduralanalgesiaaftertotalkneearthroplasty AT aymanmebeid adosereductionstudyoflocalanestheticwithadditionofdexmedetomidineonpostoperativeepiduralanalgesiaaftertotalkneearthroplasty AT ashrafmeskandr dosereductionstudyoflocalanestheticwithadditionofdexmedetomidineonpostoperativeepiduralanalgesiaaftertotalkneearthroplasty AT aymanmebeid dosereductionstudyoflocalanestheticwithadditionofdexmedetomidineonpostoperativeepiduralanalgesiaaftertotalkneearthroplasty |