Adjuvant, Analgesia, Arthroscopic Anterior Cruciate Ligament Reconstruction, Dexmedetomidine, Hyperbaric Bupivacaine, Intrathecal
Conditions
Brief summary
This study aimed to evaluate the effect of adding low doses of dexmedetomidine to hyperbaric bupivacaine during spinal anesthesia on post operative analgesia characteristics in Arthroscopic Anterior Cruciate Ligament Reconstruction Surgeries
Detailed description
The anterior cruciate ligament (ACL) is injured frequently during sports participation. Arthroscopic evaluation of patients with acute traumatic hemarthrosis of the knee has repeatedly demonstrated a 60% to 70% incidence of ACL injury. Postoperative pain should be effectively treated because it represents an important component of postoperative recovery. Effective treatment serves to blunt autonomic, somatic, and endocrine reflexes with a resultant potential decrease in perioperative morbidity. Dexmedetomidine is a highly selective α2-adrenergic agonist that has been used for premedication and as an adjunct to general anesthesia. It reduces opioid and inhalational anesthetics requirements.
Interventions
Patients received the standard spinal anesthesia with 0.5% 3 ml according to the patient hyperbaric bupivacaine only
DRUGDexmedetomidine and Hyperbaric bupivacaine
Patients received dexmedetomidine 4 μg and 0.5% (3-4 ml according to the patient height) hyperbaric bupivacaine
Sponsors
Tanta University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
21 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
* Aged from 21 to 50 years. * Both genders. * American society of anesthesiologists (ASA) physical status I and II. * Patients scheduled for arthroscopic anterior cruciate ligament reconstruction surgeries under spinal anesthesia.
Exclusion criteria
* Patient refusal. * Body Mass Index (BMI) more than 40 kg/m2. * Patients who were taking analgesics for chronic pain on opioid therapy or have a history of drug abuse. * Uncooperative patient. * Patients with coagulation disorders. * History of local anesthetics allergy. * Infection at the needle puncture site. * Patients with significant respiratory, cardiac, renal or hepatic disorders
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Total morphine consumption | 24 hours postoperatively | The rescue analgesia was morphine IV bolus of 3 mg with when VAS \> 30. Total morphine consumption in the first 24 hours postoperatively was documented. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Time to first rescue analgesia request | 24 hours postoperatively | Time to the first rescue analgesia (time from end of surgery to first dose of morphine administrated) was recorded |
| Degree of pain | 24 hours postoperatively | Degree of pain was assessed using Visual Analogue Scale (VAS). VAS (0 represents no pain while 100 represents the worst pain imaginable). VAS was assessed at PACU, 1, 2, 4, 8, 12, 18, 24 hours postoperatively. |
| Duration of motor block | Intraoperatively | Duration of motor block starting from the time when the Bromage score 3 after spinal anesthesia until the time when the Bromage score was 0 postoperative. |
| Patient satisfaction | 24 hours postoperatively | Patients' satisfaction was measured 24 hours postoperative using a five-point Likert scale consisting of: 1: Very dissatisfied, 2: Dissatisfied, 3: Unsure, 4: Satisfied, 5: Very satisfied |
| Incidence of side effects | 24 hours postoperatively | Incidence of side effects such as Hypotension, Bradycardia, Shivering, nausea, and vomiting) were recorded. |
Countries
Egypt
Outcome results
None listed