Combined Intrathecal Dexmedetomidine and Adductor Canal Block for Analgesia After Total Knee Arthroplasty

Kafrelsheikh University

Status: Enrolling

Conditions: Intrathecal Dexmedetomidine; Adductor Canal Block; Analgesia; Total Knee Arthroplasty

Treatments: Drug: Intrathecal Dexmedetomidine; Drug: Adductor Canal Block; Drug: Intrathecal Dexmedetomidine + Adductor Canal Block

Study type: Interventional

Funder types: Other

Identifiers

NCT06837844

MKSU 50-1-7

Details and patient eligibility

About

The aim of this work is to evaluate the effect of combined intrathecal dexmedetomidine and adductor canal block for analgesia after total knee arthroplasty (TKA).

Full description

Effective postoperative pain management is essential for improving patient outcomes following knee surgery, facilitating early mobilization, and reducing the risk of complications.

The adductor canal block (ACB) is a nerve block of Hunters canal, which includes the saphenous and vastus medialis nerves. Additionally, other sensory nerves, such as the femoral nerve, medial cutaneous nerve, and both the anterior branch and terminal end of the posterior branch of the obturator nerve to some extent as it enters the distal part of the canal are blocked by the ACB.

Dexmedetomidine (DXM) a highly selective α2 adrenergic agonist with sedative, anxiolytic, analgesic, sympatholytic and antihypertensive effects.

Enrollment: 75 estimated patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age from 18 to 75 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-II.
• Scheduled for total knee arthroplasty under spinal anesthesia.

Exclusion criteria

• Patients with neurological or intellectual disability.
• History of allergy to local anesthetics or dexmedetomidine .
• Infection at the injection site.
• Prolonged use of analgesic or sedative medications.
• Coagulation abnormalities.
• Pregnancy.
• Obesity [body mass index (BMI) > 30 kg/m2].

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

75 participants in 3 patient groups

Group ITD

Experimental group

Description:

Patients will receive 15mg in 3ml hyperbaric bupivacaine intrathecally with 5 μg in 0.5ml dexmedetomidine + adductor canal block using 20 ml saline 0.9% at the end of surgery

Treatment:

Drug: Intrathecal Dexmedetomidine

Group ACB

Active Comparator group

Description:

Patients will receive 15mg in 3ml hyperbaric bupivacaine intrathecally with 0.5ml saline 0.9% + adductor canal block using 20 ml bupivacaine 0.25% at the end of surgery.

Treatment:

Drug: Adductor Canal Block

Group ITD+ACB

Experimental group

Description:

Patients will receive 15mg in 3ml hyperbaric bupivacaine intrathecally with 5 μg in 0.5ml dexmedetomidine + adductor canal block using 20 ml bupivacaine 0.25% at the end of surgery.

Treatment:

Drug: Intrathecal Dexmedetomidine + Adductor Canal Block