Comparing Dexamethasone With Dexmedetomidine as Additives to Bupivacaine in Adductor Canal Block for Knee Arthroscopy.

Rasha Hamed

Status: Completed

Conditions: Pain, Postoperative

Treatments: Procedure: ultrasound-guided Adductor Canal Block + dexmedetomedine; Procedure: Spinal anaesthesia; Procedure: ultrasound-guided Adductor Canal Block; Procedure: ultrasound-guided Adductor Canal Block + dexamethasone

Study type: Interventional

Funder types: Other

Identifiers

NCT04631822

knee regional anaesthesia

Details and patient eligibility

About

a comparison shall be conducted between dexamethasone accompanied by bupivacaine, on one hand, and dexmedetomedine accompanied by bupivacaine on the other hand and a control group for pain-free knee arthroscopic surgeries.

Full description

Arthroscopic knee surgery can cause significant postoperative pain to the degree that can potentially delay timely discharge from the ambulatory surgical setting. Analgesia after knee surgery can be provided by multiple, non-systemic, non-opioid-based methods, including local anesthetic infiltration, peripheral nerve blockade, neuraxial procedures, and intra-articular injections. The femoral nerve block has been shown to be superior to traditional intra-articular injection of local anesthetics in some knee surgeries, but motor blockade of the quadriceps muscle, with the potential risk for falls, limits the value of femoral blocks for less invasive ambulatory surgery. Orthopedic surgery is increasingly being performed on an ambulatory basis, where perioperative analgesia can improve timely discharge in the outpatient setting.

Enrollment: 135 patients

Sex: All

Ages: 19 to 60 years old

Volunteers: No Healthy Volunteers

Inclusion and exclusion criteria

Inclusion Criteria: -

• Adult patients of aged more than 18 years old ASA "American Society of Anaesthesia"
• physical status I or II under-going any unilateral knee arthroscopy. Exclusion Criteria: -
• patient refusal.
• Pre-existing pain ; postoperative pain similar to preoperative pain
• Known contraindications to peripheral nerve block, including local skin infections, bleeding diathesis, and coagulopathy.
• Allergies to local anesthetics, dexmedetomidine, or any component of multimodal analgesia.

Trial design

Primary purpose: Prevention

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Triple Blind

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135 participants in 3 patient groups

Dexamethasone, combined with bupivacaine for adductor canal block

Active Comparator group

Description:

All patients will receive spinal anesthesia with 3 ml 0.5% hyperbaric bupivacaine at the L3/4 interspaces in the setting position. Ultrasound blocks will be done immediately after spinal anesthesia, before surgical intervention. In this arm, patients will receive 20 ml mixture of 0.25% bupivacaine and 8 mg dexamethasone.

Treatment:

Procedure: ultrasound-guided Adductor Canal Block + dexamethasone

Procedure: Spinal anaesthesia

Dexmedetomedine, combined with bupivacaine for adductor canal block

Active Comparator group

Description:

All patients will receive spinal anesthesia with 3 ml 0.5% hyperbaric bupivacaine at the L3/4 interspaces in the setting position. Ultrasound blocks will be done immediately after spinal anesthesia, before surgical intervention. In this arm, patients will receive 20 ml mixture of 0.25% bupivacaine and 0.5 Mg/kg dexmedetomidine.

Treatment:

Procedure: Spinal anaesthesia

Procedure: ultrasound-guided Adductor Canal Block + dexmedetomedine

control group

Active Comparator group

Description:

All patients will receive spinal anesthesia with 3 ml 0.5% hyperbaric bupivacaine at the L3/4 interspaces in the setting position. Ultrasound blocks will be done immediately after spinal anesthesia, before surgical intervention. In this arm, patients will receive 20 ml mixture of 0.25% bupivacaine with no additives

Treatment:

Procedure: ultrasound-guided Adductor Canal Block