Dexamethasone Vs. Dexmedetomidine for ESPB in Pain Management After Knee Arthroplasty

Poznan University of Medical Sciences (PUMS)

Status and phase: Enrolling; Phase 4

Conditions: Knee Arthritis; Knee Pain Chronic; Knee Disease; Knee Osteoarthritis

Treatments: Drug: Dexamethasone; Drug: Dexmedetomidine; Drug: 0.9% Sodium Chloride Injection

Study type: Interventional

Funder types: Other

Identifiers

NCT06470100

107/24

Details and patient eligibility

About

Effect of perineurial dexamethasone and dexmedetomidine on erector spinal plane block duration for knee arthroplasty

Full description

This study is proposed to explore the effect of perineurial Dexamethasone and Dexmedetomidine on erector spinal plane block duration for spine surgery.

After spine surgery, patients need good analgesia. Peripheral nerve blocks have provided a safe, effective method to control early postoperative pain when symptoms are most severe.

Local anaesthesia's much lower toxicity threshold makes it essential for its safety. An effective adjuvant, such as Dexamethasone or Dexmedetomidine, could allow for a higher dilution of local anaesthetics while maintaining and enhancing their analgesic effect.

There is considerable research comparing intravenous and perineural dexamethasone and Dexmedetomidine use in orthopaedic surgeries. However, there is a massive lack of research regarding knee surgery and the Erector Spine Plane Block.

In this study, investigators compare perineural Dexamethasone and Dexmedetomidine.

The investigator aims to find a dexamethasone or dexmedetomidine that covers the need for good pain relief and fast recovery postoperatively.

Enrollment: 90 estimated patients

Sex: All

Ages: 18 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• patients undergoing primary hip arthroplasty
• aged >18 years and <100 years
• ASA physical status 1, 2 or 3.

Exclusion criteria

• if they refused to participate,
• had a history of opioid abuse,
• had an infection of the site of needle puncture,
• were less than 18 years of age,
• were postponed as having ASA 4 or 5,
• had an allergy to any of the drugs used in the study,
• renal failure (estimated glomerular filtration rate <15ml/min/1.73m2),
• liver failure,
• known or suspected coagulopathy,
• pre-existing anatomical or neurological disorders in the lower extremities,
• intellectual disability with problems in pain evaluation,
• severe psychiatric illness.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Quadruple Blind

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90 participants in 3 patient groups, including a placebo group

Control group

Placebo Comparator group

Description:

0.2% ropivacaine for erector spinae plane block

Treatment:

Drug: 0.9% Sodium Chloride Injection

Dexamethasone

Experimental group

Description:

0.2% ropivacaine + 4mg Dexamethasone for erector spinae plane block

Treatment:

Drug: Dexamethasone

Dexmedetomidine

Experimental group

Description:

0.2% ropivacaine + 50ug Dexmedetomidine for erector spinae plane block

Treatment:

Drug: Dexmedetomidine