Effectiveness of intra-articular dexmedetomidine as postoperative analgesia in arthroscopic knee surgery (A comparative study)
Journal Title: IOSR Journal of Pharmacy (IOSRPHR) - Year 2015, Vol 5, Issue 7
Abstract
ABSTRACT: Background And Objectives: To study the effect of inj.Ropivacaine (0.25%) 2mg/kg with and without Inj.Dexmedetomidine (1-2µg/kg) intraarticularly for postoperative analgesia in arthroscopic knee surgery.1:To Evaluate Onset, Duration and analgesic efficacy of Intraarticular Dexmedetomidine2: To monitor the safety of Dexmedetomidine and Ropivacaine. Methods: A prospective randomized double blind study, was conducted in 50 patients undergoing elective arthroscopy of knee joint under spinal anaesthesia. At the completion of the surgery, all patients were divied into two groups;GroupP(n=25):received Inj. Ropivacaine 0.25% and GroupD(n=25):received Inj.Ropivacaine(0.25%)+Inj. Dexmedetomidine(1µg/kg) total volume 20 ml was deposited intraarticularly.Patients were monitored in the postoperative ward for the hemodynamic parameters and their Sedation score was assessed.. The efficacy of the drug was determined by improvement in VAS score, duration of analgesia and total number of rescue analgesics during 24 hr in post operative period. Results: There was no statistically significant differences observed in heart rate except changes at 6 and 8 hr. At 6 and 8 hr in group P pulse (82.48 ± 7.49, 81.44 ± 8.78) as compared to group D (75.38 ± 6.52, 74.96 ± 5.70),because of duration of action of ropivacaine with or without dexmedetomidine.There was no statistically significant difference in blood pressure was found, except at 12 hour and 24 hour (p=0.018), because of longer duration of action of intrarticular dexmedetomidine with ropivacaine in group D.At 6 hrs patients in Group P had a mean VAS score of 3.2 as compared to VAS score values of 1.8 in Group D which is statistically significant..At 2 , 4, 6 and 8 hour VAS score in P group was 1.64, 2.44, 3.24, 2.84 respectively. As compared to group P, in group D VAS score at 2, 4, 6 and 8 hour was 0.92, 1.04, 1.79 and 2.08 respectively. So VAS score lower in group D as compared to group P at 2, 4, 6 and 8 hrs. Conclusion: Dexmedetomidine when administered as an adjuvant to ropivacaine via intraarticular route produces longer duration of analgesia as compared to local anaesthetic drug alone resulting in lower pain scores and decreases need for postoperative analgesics with minimal side effects and no effect on hemodynamic parameters when used in low dose.Thus, intraarticular use of Inj.Dexmedetomidine is an effective adjuvant to ropivacaine for post operative analgesia following arthroscopy of the knee
Authors and Affiliations
Dr. Tarlika P, Doctor, , Dr. Divyang Dalwadi, 3, Dr. Keta Thakkar, 4, Dr. Prabhanjan Singh
Keywords
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