Onset and Duration of Sensory and Motor Block of Femoral Nerve,, Time to First Request of Rescue Analgesics,, Total Morphine Consumption in 24 Hours, Visual Analogue Pain Scores,
Conditions
Keywords
femoral nerve block, peri-neural dexmedetomidine
Brief summary
The duration of sensory block after single dose of long acting local anesthetics is not sufficient to avoid the postoperative use of opioids. Alpha-2 adrenoceptor agonists such as clonidine have been shown to increase the duration of peripheral nerve block. Dexmedetomidine is a more potent and selective α-2-adrenoceptor compared to clonidine. To the best of our knowledge, the use of Dexmedetomidine as adjuvant to local anesthetic was not previously reported for femoral nerve block.
Interventions
ultrasound quided femoral nerve block with injection of 15 ml bupivacaine 0.5% perineurally with 0.5 ml dexmedetomidine (50 microgram) either perineurally or subcutaneously. After adequate assessment of femoral nerve block, patients will be transferred to the operating room to receive a standard general anesthesia
Sponsors
anesthesia department
faculty of medicine
Cairo University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
SUPPORTIVE_CARE
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 45 Years
Healthy volunteers
No
Inclusion criteria
* all patients with ASA physical status I or II, scheduled for diagnostic knee arthroscopy
Exclusion criteria
* Patients who are refusing regional block, patients with diabetic peripheral neuropathy, renal or hepatic dysfunction, inflammation or infection at the puncture site, and history of allergic reaction to study medications
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The primary outcome measure of this study will be the change of sensory block over time. | intraoperatively every 5 minutes for the first 30 minutes of the operation, then postoperatively every 2 hours for 24hours | Over a period of 30 min after injection of the study medications, a blinded investigator will assess sensory block with pinprick test using a 3-point scale: 0 ═ complete loss of sensation, 1 ═ partial loss of sensation and 2 ═ normal sensation (10). Pinprick test will be done in comparison to the contralateral area at the sensory distribution of the femoral nerve |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| onset of motor and sensory block | up to 30 minutes after the end of injection | The onset time of sensory and motor block will be: the time elapsed between the end of injection and the development of complete block (score of 0 at all dermatomes or no movement of the quadriceps muscle. |
Other
| Measure | Time frame | Description |
|---|---|---|
| duration of motor block | interval between time of injection and complete motor power recover | The duration of motor block will be defined as: the time interval between the end of injection and the complete recovery of motor power of the quadriceps muscle). |
| Visual analogue pain scores (resting and dynamic) and Richmond Agitation-Sedation Score (RASS) ( | 2hours post operative and for 24hours | Visual analogue pain scores (resting and dynamic) and Richmond Agitation-Sedation Score (RASS) (12) will be assessed at 2, 4, 6, 8, 12, 16, and 24 hours postoperatively |
| time of 1st request of rescue analgesia | over the poatoperative 24hours | The time to the first request of rescue postoperative analgesic will be: the time interval between the onset of successful sensory block and the first request to postoperative analgesia |
Countries
Egypt
Outcome results
None listed