Knee Arthritis, Knee Disease, Knee Osteoarthritis, Knee Pain Chronic
Conditions
Brief summary
Effect of perineurial dexamethasone and dexmedetomidine on erector spinal plane block duration for knee arthroplasty
Detailed description
This study is proposed to explore the effect of perineurial Dexamethasone and Dexmedetomidine on erector spinal plane block duration for knee surgery. After knee surgery, patients need good analgesia. Peripheral nerve blocks have provided a safe, effective method to control early postoperative pain when symptoms are most severe. Local anaesthesia's much lower toxicity threshold makes it essential for its safety. An effective adjuvant, such as Dexamethasone or Dexmedetomidine, could allow for a higher dilution of local anaesthetics while maintaining and enhancing their analgesic effect. There is considerable research comparing intravenous and perineural dexamethasone and Dexmedetomidine use in orthopaedic surgeries. However, there is a massive lack of research regarding knee surgery and the Erector Spine Plane Block. In this study, investigators compare perineural Dexamethasone and Dexmedetomidine. The investigator aims to find a dexamethasone or dexmedetomidine that covers the need for good pain relief and fast recovery postoperatively.
Interventions
DRUG0.9% Sodium Chloride Injection
unilateral administration of 20ml of 0,2% ropivacaine + 2ml 0.9% sodium chloride for the erector spine plane block
DRUGDexamethasone
unilateral administration of 20ml of 0,2% ropivacaine with 4mg Dexamethasone for the erector spine plane block
DRUGDexmedetomidine
unilateral administration of 20ml of 0,2% ropivacaine with 50ug Dexmedetomidine for the erector spine plane block
Sponsors
Poznan University of Medical Sciences
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 100 Years
Healthy volunteers
No
Inclusion criteria
* patients undergoing primary hip arthroplasty * aged \>18 years and \<100 years * ASA physical status 1, 2 or 3.
Exclusion criteria
* if they refused to participate, * had a history of opioid abuse, * had an infection of the site of needle puncture, * were less than 18 years of age, * were postponed as having ASA 4 or 5, * had an allergy to any of the drugs used in the study, * renal failure (estimated glomerular filtration rate \<15ml/min/1.73m2), * liver failure, * known or suspected coagulopathy, * pre-existing anatomical or neurological disorders in the lower extremities, * intellectual disability with problems in pain evaluation, * severe psychiatric illness.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| first need of opiate | 48 hours after surgery | Time after surgery when the patient needs opiate for the first time |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Opioid consumption | 48 hours after surgery | Total opioid consumption after surgery |
| Numerical Rating Scale [range 0:10] | 4 hours after surgery | NRS (Numerical Rating Scale; 0 - no pain; 10 - the worst pain ever) |
| Nerve damage [range 0-4] | 12 hours after surgery | Nerve damage assesment will be performed using the nerve damage score (N0- no nerve damage; N1- minor - sensory paresthesia; N2- major -complete sensory anesthesia; N3- Complete- complete motor defect with or without paraesthesia; N4-CRPS- Complex Regional Pain Syndrome) |
Countries
Poland
Contacts
STUDY_CHAIRMalgorzata Domagalska, M.D. PhD.
Poznań University of Medical Science
Outcome results
None listed