Dexmedetomidine Prolongs the Analgesic Effects of Periarticular Infiltration Analgesia following Total Knee Arthroplasty: A Prospective,Double-Blind,Randomized Controlled Trial |
| |
| Affiliation: | 1. Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, People’s Republic of China;2. West China School of Nursing, Sichuan University/Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China;1. Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota;2. Department of Orthopedic Surgery, Orthopedic Surgery Artificial Intelligence Lab (OSAIL), Mayo Clinic, Rochester, Minnesota;1. Orlando Health Jewett Orthopedic Institute, Orlando, Florida;2. OrthoCarolina—Hip & Knee Center, Charlotte, North Carolina;3. OrthoCarolina Research Institute, Charlotte, North Carolina;4. Atrium Health—Musculoskeletal Institute, Charlotte, North Carolina;1. Universidad Icesi, Facultad de Ciencias de la Salud, Cali, Colombia;2. Fundación Valle del Lili, Centro de Investigaciones Clínicas, Cali, Colombia;3. Fundación Valle del Lili, Departamento de Ortopedia y Traumatología, Cali, Colombia;1. Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana;2. Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan;1. Department of Orthopaedic Surgery, Washington University, Saint Louis, Missouri;2. Orthopaedic Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York;3. Rothman Orthopedic Institute at Thomas Jefferson University, Philadelphia, Pennsylvania;4. Maine Medical Partners Orthopedics and Sports Medicine, South Portland, Maine |
| |
| Abstract: | BackgroundPeriarticular infiltration analgesia (PIA) is widely administered to relieve postoperative pain following total knee arthroplasty (TKA). The present study aimed to evaluate the effect of prolonging the analgesic duration by adding dexmedetomidine to PIA for pain management after TKA.MethodsOne hundred and sixteen patients were randomly allocated into 3 groups based on PIA regimens including group R (ropivacaine), group E (ropivacaine plus epinephrine), and group D (ropivacaine plus dexmedetomidine). The primary outcomes were postoperative visual analog scale scores, time until the administration of first rescue analgesia, and opioid consumption. The secondary outcomes included postoperative inflammatory biomarkers and functional recovery. The tertiary outcomes were postoperative complications and adverse events.ResultsThe patients in group D had significantly lower resting visual analog scale scores than those in groups R and E at 6 hours after surgery. Group R showed the higher pain scores at rest and motion than groups D and E 12 hours postoperatively. The use of dexmedetomidine or epinephrine postponed the time until the administration of first rescue analgesia and led to lower opioid consumption in the first 24 hours after TKA. The levels of interleukin-8 and tumor necrosis factor-α in groups D and E were significantly lower than those in group R on postoperative day 3. Furthermore, no significant differences were observed in functional recovery, postoperative complications, or adverse events among the three groups.ConclusionsAdding dexmedetomidine as an adjuvant to PIA could potentiate and prolong the analgesic effect in the early stage following TKA without increasing the risk of adverse events. |
| |
| Keywords: | total knee arthroplasty periarticular infiltration analgesia pain dexmedetomidine analgesia |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
