title: Intra-articular Adjuvant Analgesics following Knee Arthroscopy: Comparison between Single and Double Dose Dexmedetomidine and Ropivacaine A Multicenter Prospective Double-blind Trial.
abstract: OBJECTIVE
  Knee arthroscopy is a commonly performed orthopedic procedure. Post-operatively, adequate pain relief reduces the surgical stress response and patient's morbidity and facilitates rehabilitation. The analgesic effect of dexmedetomidine (2 μg/kg body weight) as an adjunct to ropivacaine in knee arthroscopic knee procedures was studied to determine whether this would achieve longer post-operative analgesia and whether the study dosage of dexmedetomidine was safe and free of adverse effects.
  
  
  METHODS
  In a multicenter prospective double blind trial of sixty patients undergoing knee arthroscopic procedures, patients were randomly assigned to three groups: Group R, receiving intra-articular ropivacaine (20 mL); Group D1 (18 mL ropivacaine, dexmedetomidine 1 μg/kg body weight); and Group D2 (18 mL ropivacaine, dexmedetomidine 2 μg/kg).
  
  
  RESULTS
  Group D2 had significantly lower pain scores for the first 12 postoperative hours than Group D1 and Group R. Time to first analgesic requirement was longest in Group D2 (757.30 ± 207.68 min), followed by Group D1 (433.2 ± 54.3 min) and Group R (311.80 ± 61.56 min); these differences were significant (P < 0.05). Total analgesic requirement was significantly lower in Group D2 (82.50 ± 48.05 mg; P < 0.05). Intensity of pain was significantly less in Group D2 in the third (P < 0.01) and sixth hours (P < 0.05).
  
  
  CONCLUSIONS
  Intra-articular dexmedetomidine (2 μg/kg) has superior analgesic efficacy, delayed the first postoperative requirement for analgesia and decreasing the need for postoperative analgesics with no major adverse effects.
authors: Department of Orthopaedics, Hi-Tech Medical College, Bhubaneswar, Odisha, India.
authors: Ranajit
authors: R
authors: Panigrahi
authors: Department of Anaesthesia, Hi-Tech Medical College, Bhubaneswar, Odisha, India.
authors: Ritesh
authors: R
authors: Roy
authors: Department of Physiology, Hi-Tech Medical College, Bhubaneswar, Odisha, India.
authors: Amita Kumari
authors: AK
authors: Mahapatra
authors: Department of Pharmacology, Hi-Tech Medical College, Bhubaneswar, Odisha, India.
authors: Anju
authors: A
authors: Prasad
authors: Department of Orthopaedics, Hi-Tech Medical College, Bhubaneswar, Odisha, India.
authors: Ashok
authors: A
authors: Priyadarshi
authors: Department of Orthopaedics, Hi-Tech Medical College, Bhubaneswar, Odisha, India.
authors: Nishit
authors: N
authors: Palo
mesh_terms: D000328:Adult; D000577:Amides / Q000008:administration & dosage*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D001182:Arthroscopy / Q000009:adverse effects / Q000379:methods*; D001794:Blood Pressure / Q000187:drug effects; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000517:prevention & control; D011182:Postoperative Care; D011446:Prospective Studies; D000077212:Ropivacaine; D055815:Young Adult
chemical_list: D000577:Amides; D018712:Analgesics, Non-Narcotic; D000779:Anesthetics, Local; D004338:Drug Combinations; D020927:Dexmedetomidine; D000077212:Ropivacaine
keywords: Arthroscopy; Dexmedetomidine; Pain relief