Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trial
Abstract Background Comparison of whether intrathecal dexmedetomidine prolongs spinal anesthesia-associated sensorimotor blockade more than intravenous infusion during knee arthroscopy procedures performed under subarachnoid blockade. Methods Ninety patients aged 18–75 years, ASA class I-II, who und...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | BMC Anesthesiology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12871-023-02401-9 |
| _version_ | 1797362935417274368 |
|---|---|
| author | Shujiao Liu Yaorui Sun YeWen Wang Chao Sun Quanyi Zhang |
| author_facet | Shujiao Liu Yaorui Sun YeWen Wang Chao Sun Quanyi Zhang |
| author_sort | Shujiao Liu |
| collection | DOAJ |
| description | Abstract Background Comparison of whether intrathecal dexmedetomidine prolongs spinal anesthesia-associated sensorimotor blockade more than intravenous infusion during knee arthroscopy procedures performed under subarachnoid blockade. Methods Ninety patients aged 18–75 years, ASA class I-II, who underwent knee arthroscopy between October 2022 and April 2023 were randomized into intrathecal、intravenous and control groups.Subjects received three modes of administration: an intrathecal group (2 ml of 1% ropivacaine + 1 ml of 5 μg dexmedetomidine, along with intravenous saline infusion), an intravenous group (intrathecal 2 ml of 1% ropivacaine + 1 ml of 0.9% saline, with dexmedetomidine pumped intravenously at a dose of 0.5 μg/kg/h), and a control group (intrathecal 2 ml of 1% ropivacaine + 1 ml of 0.9% saline, along with intravenous saline infusion). Total analgesic duration, duration of sensory and motor blockade, Ramsay sedation score, Visual Analogue Score (VAS) at different postoperative time points, and occurrence of adverse effects were recorded. Results The total analgesia duration was significantly longer in the intrathecal group than in the intravenous and control groups (352.13 ± 51.70 min VS 273.47 ± 62.57 min VS 241.41 ± 59.22 min, P < 0.001).The onset of sensory block was shorter in the intrathecal group than in the intravenous and control groups (4 [3–4]min VS 5 [4–5]min VS 5 [4–5]min; P < 0.001);the onset of motor block was shorter in the intrathecal group than in the intravenous group and the control group (5 [4–5]min VS 5 [5–6]min VS 6[5.5–7]min; P < 0.001).Sedation scores were higher in the intravenous group than in the intrathecal and control groups (P < 0.001). At 5 h postoperatively, the VAS score in the intrathecal group was lower than that in the intravenous and control groups (P < 0.001). At 24 h postoperatively, the VAS score in the intrathecal group was lower than that in the control group (P < 0.001). In addition, the incidence of bradycardia was significantly higher in the intravenous group than in the intrathecal and control groups (30%, 6.5%, and 3.4%, respectively; P = 0.018, P = 0.007). Conclusions Intrathecal administration of dexmedetomidine did prolong the total analgesia duration, as well as accelerate the onset of sensory-motor blockade compared with intravenous infusion, and did not result in any hemodynamic instability or other adverse events at the doses studied. Trial registration This single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 26/09/2023 with the registration number ChiCTR2300076170. |
| first_indexed | 2024-03-08T16:14:34Z |
| format | Article |
| id | doaj.art-a14ba9332e73481e9c1fc9a767889d51 |
| institution | Directory Open Access Journal |
| issn | 1471-2253 |
| language | English |
| last_indexed | 2024-03-08T16:14:34Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Anesthesiology |
| spelling | doaj.art-a14ba9332e73481e9c1fc9a767889d512024-01-07T12:41:48ZengBMCBMC Anesthesiology1471-22532024-01-012411910.1186/s12871-023-02401-9Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trialShujiao Liu0Yaorui Sun1YeWen Wang2Chao Sun3Quanyi Zhang4Department of Anesthesiology, Binzhou Medical University HospitalDepartment of Anesthesiology, Binzhou Medical University HospitalDepartment of Anesthesiology, Binzhou Medical University HospitalDepartment of Anesthesiology, Binzhou Medical University HospitalDepartment of Anesthesiology, Binzhou Medical University HospitalAbstract Background Comparison of whether intrathecal dexmedetomidine prolongs spinal anesthesia-associated sensorimotor blockade more than intravenous infusion during knee arthroscopy procedures performed under subarachnoid blockade. Methods Ninety patients aged 18–75 years, ASA class I-II, who underwent knee arthroscopy between October 2022 and April 2023 were randomized into intrathecal、intravenous and control groups.Subjects received three modes of administration: an intrathecal group (2 ml of 1% ropivacaine + 1 ml of 5 μg dexmedetomidine, along with intravenous saline infusion), an intravenous group (intrathecal 2 ml of 1% ropivacaine + 1 ml of 0.9% saline, with dexmedetomidine pumped intravenously at a dose of 0.5 μg/kg/h), and a control group (intrathecal 2 ml of 1% ropivacaine + 1 ml of 0.9% saline, along with intravenous saline infusion). Total analgesic duration, duration of sensory and motor blockade, Ramsay sedation score, Visual Analogue Score (VAS) at different postoperative time points, and occurrence of adverse effects were recorded. Results The total analgesia duration was significantly longer in the intrathecal group than in the intravenous and control groups (352.13 ± 51.70 min VS 273.47 ± 62.57 min VS 241.41 ± 59.22 min, P < 0.001).The onset of sensory block was shorter in the intrathecal group than in the intravenous and control groups (4 [3–4]min VS 5 [4–5]min VS 5 [4–5]min; P < 0.001);the onset of motor block was shorter in the intrathecal group than in the intravenous group and the control group (5 [4–5]min VS 5 [5–6]min VS 6[5.5–7]min; P < 0.001).Sedation scores were higher in the intravenous group than in the intrathecal and control groups (P < 0.001). At 5 h postoperatively, the VAS score in the intrathecal group was lower than that in the intravenous and control groups (P < 0.001). At 24 h postoperatively, the VAS score in the intrathecal group was lower than that in the control group (P < 0.001). In addition, the incidence of bradycardia was significantly higher in the intravenous group than in the intrathecal and control groups (30%, 6.5%, and 3.4%, respectively; P = 0.018, P = 0.007). Conclusions Intrathecal administration of dexmedetomidine did prolong the total analgesia duration, as well as accelerate the onset of sensory-motor blockade compared with intravenous infusion, and did not result in any hemodynamic instability or other adverse events at the doses studied. Trial registration This single-center, prospective, RCT has completed the registration of the Chinese Clinical Trial Center at 26/09/2023 with the registration number ChiCTR2300076170.https://doi.org/10.1186/s12871-023-02401-9DexmedetomidineSubarachnoid blockKnee arthroscopy |
| spellingShingle | Shujiao Liu Yaorui Sun YeWen Wang Chao Sun Quanyi Zhang Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trial BMC Anesthesiology Dexmedetomidine Subarachnoid block Knee arthroscopy |
| title | Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trial |
| title_full | Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trial |
| title_fullStr | Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trial |
| title_full_unstemmed | Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trial |
| title_short | Comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures: a randomized controlled trial |
| title_sort | comparison of the effect of dexmedetomidine intrathecal injection and intravenous infusion on subarachnoid blockade during knee arthroscopy procedures a randomized controlled trial |
| topic | Dexmedetomidine Subarachnoid block Knee arthroscopy |
| url | https://doi.org/10.1186/s12871-023-02401-9 |
| work_keys_str_mv | AT shujiaoliu comparisonoftheeffectofdexmedetomidineintrathecalinjectionandintravenousinfusiononsubarachnoidblockadeduringkneearthroscopyproceduresarandomizedcontrolledtrial AT yaoruisun comparisonoftheeffectofdexmedetomidineintrathecalinjectionandintravenousinfusiononsubarachnoidblockadeduringkneearthroscopyproceduresarandomizedcontrolledtrial AT yewenwang comparisonoftheeffectofdexmedetomidineintrathecalinjectionandintravenousinfusiononsubarachnoidblockadeduringkneearthroscopyproceduresarandomizedcontrolledtrial AT chaosun comparisonoftheeffectofdexmedetomidineintrathecalinjectionandintravenousinfusiononsubarachnoidblockadeduringkneearthroscopyproceduresarandomizedcontrolledtrial AT quanyizhang comparisonoftheeffectofdexmedetomidineintrathecalinjectionandintravenousinfusiononsubarachnoidblockadeduringkneearthroscopyproceduresarandomizedcontrolledtrial |