Nerve Block, Dexmedetomidine
Conditions
Keywords
femoral nerve blockade, dexmedetomidine, ropivacaine, anesthesia
Brief summary
The aim of the study was to find out whether addition of dexmedetomidine to lower concentration of ropivacaine preoperatively in femoral nerve block (FNB) would intensify analgesia and preserve quadriceps muscle strength after TKA.
Detailed description
We designed this study to evaluate whether dexmedetomidine added to lower concentration of ropivacaine for FNB can intensify analgesic effect and meanwhile reduce the possibility of lower limb (or quadriceps) weakness. Three groups were compared: 0.2% ropivacaine (H group), 0.1% ropivacaine (L group) and ropivacaine 0.1% added with 2 μg/kg dexmedetomidine (LD group).
Interventions
DRUGDexmedetomidine
Dexmedetomidine added to lower concentration of ropivacaine for postoperative analgesia in FNB
ultrasound-guided femoral nerve block, a single bolous of 20 ml ropivacaine (concentration 0.2% for H group or 0.1% for L group) before surgery followed by continuous femoral nerve block using an infusion rate of ropivacaine 0.2% 5 ml/h for postoperative analgesia started right after surgery
DEVICEintravenous patient-controlled analgesia pump with morphine
All subjects received intravenous patient-controlled analgesia (IV-PCA) pumps to measure additional morphine consumption, which included 50 mg morphine in 50 ml saline: bolus 2 mg; lock out time, 15 minutes.
PROCEDUREContinuous femoral nerve block
All the continuous femoral nerve block infusion regimes in the pump were connected to CFNB catheter, which contained only ropivacaine with different concentrations (ropivacaine 0.1% for L group and LD group; ropivacaine 0.2% for H group, 5 ml/h).
Sponsors
First Affiliated Hospital, Sun Yat-Sen University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Caregiver, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
50 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* ASA I-II * scheduled for total knee arthroplasty
Exclusion criteria
* refusal to participate in this study * unicompartmental knee arthroplasty * BMI \> 35 kg/m2 * congnitive or phychiatric history * refusal of general anesthesia * contraindication to laryngeal mask airway insertion * contraindication to peripheral nerve block (localized infections, sepsis, coagulopathy, bleeding diathesis or preexisting lower extremity neurological abnormality) * allergy to the drugs used
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of manual muscle testing (MMT) over 72 hours postoperatively | 0-72 hours postoperatively | The MMT grading was recorded from 0 to 5 to measure muscle strength at 6, 12, 24, 36, 48 and 72 hours after surgery. |
| Change of Timed Up and Go test (TUG) over 72 hours postoperatively | 0-72 hours postoperatively | TUG test was used to assess the patient's mobility that requires both balance and static. It was measured at 24, 48 and 72 hours after surgery. |
| Change of numeric rating scales (NRS) over 72 hours postoperatively | 0-72 hours postoperatively | NRS was used to evaluate postoperative pain control. They were measured at 6, 12, 24, 36, 48 and 72 hours after surgery. |
Countries
China
Outcome results
None listed