Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty
Background The shivering effect after spinal anesthesia in total knee arthroplasty (TKA) is challenging for anesthesiologists. This study aimed to compare two administration routes of dexmedetomidine as a post-neuraxial shivering prevention measure and an adjunctive analgesic and sedative agent. Met...
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| Format: | Article |
| Language: | English |
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Korean Society of Anesthesiologists
2023-08-01
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| Series: | Korean Journal of Anesthesiology |
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| Online Access: | http://ekja.org/upload/pdf/kja-22579.pdf |
| _version_ | 1797771623319732224 |
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| author | Maha Ahmed Abo-Zeid Salim Sherine Bakrey Rania Elmohamady Elbadrawy |
| author_facet | Maha Ahmed Abo-Zeid Salim Sherine Bakrey Rania Elmohamady Elbadrawy |
| author_sort | Maha Ahmed Abo-Zeid Salim |
| collection | DOAJ |
| description | Background The shivering effect after spinal anesthesia in total knee arthroplasty (TKA) is challenging for anesthesiologists. This study aimed to compare two administration routes of dexmedetomidine as a post-neuraxial shivering prevention measure and an adjunctive analgesic and sedative agent. Methods Fifty-six patients were randomly allocated into two equal groups. The intravenous dexmedetomidine (IV dex) group received an IV infusion of 0.5 µg/kg dexmedetomidine diluted in 20 ml saline and an adductor canal block (ACB) consisting of 20 ml of 0.25% levobupivacaine and 1 ml saline. The adductor canal block dexmedetomidine (ACB dex) group received a 20 ml IV infusion of saline and an ACB consisting of 20 ml 0.25% levobupivacaine and 1 ml of 0.5 µg/kg dexmedetomidine. Results The incidence of shivering 1 h post spinal anesthesia was equal in both groups (50%); however, the shivering grade was significantly lower in the IV dex group 1 h postoperatively. The onset of sensory block was significantly later in the IV dex group (22.14 ± 2.52 min) than in the ACB dex group (12 ± 3.31 min). Postoperative analgesic duration (h) was significantly longer in the ACB dex group (12.28 ± 4.47) compared to the IV dex group (9.28 ± 1.90). The sedation scores were also significantly higher in the IV dex group in the preoperative, intraoperative, and immediate postoperative periods. Conclusions While perineural ACB dexmedetomidine had similar intraoperative anti-shivering with less sedative effects as IV dexmedetomidine, it was associated with both less shivering control and superior analgesia post-TKA under spinal anesthesia. |
| first_indexed | 2024-03-12T21:40:16Z |
| format | Article |
| id | doaj.art-3d864219747e4db08ba2aa1fcae532a2 |
| institution | Directory Open Access Journal |
| issn | 2005-6419 2005-7563 |
| language | English |
| last_indexed | 2024-03-12T21:40:16Z |
| publishDate | 2023-08-01 |
| publisher | Korean Society of Anesthesiologists |
| record_format | Article |
| series | Korean Journal of Anesthesiology |
| spelling | doaj.art-3d864219747e4db08ba2aa1fcae532a22023-07-27T00:56:44ZengKorean Society of AnesthesiologistsKorean Journal of Anesthesiology2005-64192005-75632023-08-0176430731610.4097/kja.225798881Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplastyMaha Ahmed Abo-Zeid Salim0Sherine Bakrey1Rania Elmohamady Elbadrawy Department of Anesthesia and Surgical Intensive Care, Mansoura Faculty of Medicine, Al Mansurah, Egypt Department of Anesthesia and Surgical Intensive Care, Mansoura Faculty of Medicine, Al Mansurah, EgyptBackground The shivering effect after spinal anesthesia in total knee arthroplasty (TKA) is challenging for anesthesiologists. This study aimed to compare two administration routes of dexmedetomidine as a post-neuraxial shivering prevention measure and an adjunctive analgesic and sedative agent. Methods Fifty-six patients were randomly allocated into two equal groups. The intravenous dexmedetomidine (IV dex) group received an IV infusion of 0.5 µg/kg dexmedetomidine diluted in 20 ml saline and an adductor canal block (ACB) consisting of 20 ml of 0.25% levobupivacaine and 1 ml saline. The adductor canal block dexmedetomidine (ACB dex) group received a 20 ml IV infusion of saline and an ACB consisting of 20 ml 0.25% levobupivacaine and 1 ml of 0.5 µg/kg dexmedetomidine. Results The incidence of shivering 1 h post spinal anesthesia was equal in both groups (50%); however, the shivering grade was significantly lower in the IV dex group 1 h postoperatively. The onset of sensory block was significantly later in the IV dex group (22.14 ± 2.52 min) than in the ACB dex group (12 ± 3.31 min). Postoperative analgesic duration (h) was significantly longer in the ACB dex group (12.28 ± 4.47) compared to the IV dex group (9.28 ± 1.90). The sedation scores were also significantly higher in the IV dex group in the preoperative, intraoperative, and immediate postoperative periods. Conclusions While perineural ACB dexmedetomidine had similar intraoperative anti-shivering with less sedative effects as IV dexmedetomidine, it was associated with both less shivering control and superior analgesia post-TKA under spinal anesthesia.http://ekja.org/upload/pdf/kja-22579.pdfdexmedetomidineknee arthroplastylevobupivacainenerve blockshiveringspinal anesthesia |
| spellingShingle | Maha Ahmed Abo-Zeid Salim Sherine Bakrey Rania Elmohamady Elbadrawy Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty Korean Journal of Anesthesiology dexmedetomidine knee arthroplasty levobupivacaine nerve block shivering spinal anesthesia |
| title | Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty |
| title_full | Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty |
| title_fullStr | Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty |
| title_full_unstemmed | Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty |
| title_short | Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty |
| title_sort | intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty |
| topic | dexmedetomidine knee arthroplasty levobupivacaine nerve block shivering spinal anesthesia |
| url | http://ekja.org/upload/pdf/kja-22579.pdf |
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