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VOLUME 3 , ISSUE 2 ( May-August, 2017 ) > List of Articles

ORIGINAL ARTICLE

Comparative Evaluation of Intra-articular Bupivacaine vs Intra-articular Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgery

Chitra Chatterji, Chetan Mehra, Varadarajan Muralidhar, Harsha Madhok, Atish Pal

Citation Information : Chatterji C, Mehra C, Muralidhar V, Madhok H, Pal A. Comparative Evaluation of Intra-articular Bupivacaine vs Intra-articular Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgery. J Recent Adv Pain 2017; 3 (2):71-76.

DOI: 10.5005/jp-journals-10046-0072

License: CC BY 3.0

Published Online: 01-12-2015

Copyright Statement:  Copyright © 2017; The Author(s).


Abstract

Aim

To assess the postoperative analgesic effect of intra-articular dexmedetomidine, when administered as an adjuvant with bupivacaine in arthroscopic knee surgeries.

Materials and methods

A total of 60 patients undergoing elective unilateral knee arthroscopy under general anesthesia were randomly assigned to two groups (n = 30). Group Bupivacaine and Saline (BS) received intra-articularly 19 mL of 0.5% bupivacaine and 1 mL of isotonic saline (total volume 20 mL). Group Bupivacaine and Dexmedetomidine (BD) received intra-articular 100 µg dexmedetomidine (1 mL) added to 19 mL of 0.5% bupivacaine. Pain assessment using visual analog scale (VAS) was done at regular intervals for 24 hours and rescue analgesia given accordingly.

Results

Increased VAS scores (p-value 0.005, <0.001, 0.002) and increased use of supplementary analgesic (p-value 0.042, 0.026, 0.024) were seen in group BS (control group) compared with group BD (study group), at intervals of 30 minutes, 1 hour, and 2 hours. Mean duration of analgesia (time for first analgesic requirement) was longer in group BD (median 4 hours) compared with BS (median 1 hour) (p-value 0.012).

Conclusion

Intra-articular dexmedetomidine administered as an adjuvant to bupivacaine improves the quality and duration of postoperative analgesia after knee arthroscopy.

Clinical significance

A myriad of agents have been studied for their potential use in attenuating postoperative pain following knee arthroscopy, but despite multiple studies with various agents, no single agent has been found to be clearly superior to the rest. In such a scenario, dexmedetomidine provides an interesting option.

How to cite this article

Pal A, Chatterji C, Muralidhar V, Mehra C, Madhok H. Comparative Evaluation of Intra-articular Bupivacaine vs Intra-articular Bupivacaine and Dexmedetomidine for Postoperative Analgesia in Arthroscopic Knee Surgery. J Recent Adv Pain 2017;3(2):71-76.


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