Clinical analgesic efficacy and side effects of dexmedetomidine in the early postoperative period after arthroscopic knee surgery.
OBJECTIVE
To determine the analgesic efficacy of dexmedetomidine in the early postoperative period.


METHODS
Randomized, double-blind, double placebo-controlled clinical trial.


METHODS
University medical center.


METHODS
30 ASA physical status I, II, and III patients with cruciate ligament lesion and joint fibrosis who were scheduled for knee arthroscopy.


METHODS
Patients were prospectively randomized to receive dexmedetomidine one mcg/kg(-1) intravenously (IV), for 10 minutes followed by dexmedetomidine 0.3 mcg/kg(-1) for 50 minutes or propacetamol two g, IV, for 10 minutes.


METHODS
Pain scores, time to onset analgesia, and morphine consumption were measured. Open-label rescue morphine 5 mg IV was available as needed during the postdosing evaluation period of 8 hours. Hemodynamic data, sedation scores, and renal and hepatic function were assessed for control of adverse events.


RESULTS
Pain scores with dexmedetomidine and propacetamol were similar. There were no differences in the number of patients who required supplemental rescue analgesia (7/15 vs 4/15; P = 0.44), but total morphine requirements were higher with dexmedetomidine (45 mg) versus propacetamol (20 mg) in the 8-hour follow-up (P < 0.05). The most frequent adverse events with dexmedetomidine were bradycardia and hypertension.


CONCLUSIONS
Dexmedetomidine provides a modest analgesic effect after knee arthroscopy, but the side effects of this drug, such as hypertension and bradycardia, may restrict the use of large bolus doses.
Gómez-Vázquez
Maria E
ME
Department of Anesthesiology, HGR No 110, Instituto Mexicano del Seguro Social and CUCS, Universidad de Guadalajara, Guadalajara 44700, Mexico. maegova9@gmail.com
Hernández-Salazar
Eduardo
E
Hernández-Jiménez
Abel
A
Pérez-Sánchez
Arturo
A
Zepeda-López
Vilma A
VA
Salazar-Páramo
Mario
M
D000082:Acetaminophen / Q000008:administration & dosage / Q000031:analogs & derivatives; D000328:Adult; D000698:Analgesia / Q000009:adverse effects / Q000379:methods*; D018712:Analgesics, Non-Narcotic / Q000009:adverse effects / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D001182:Arthroscopy / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D001919:Bradycardia / Q000139:chemically induced; D020927:Dexmedetomidine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage; D010147:Pain Measurement / Q000187:drug effects / Q000706:statistics & numerical data; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011184:Postoperative Period; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; C063776:propacetamol; D020927:Dexmedetomidine; D009020:Morphine