Intra-articular dexmedetomidine and clonidine for postoperative analgesia in arthroscopic knee surgery

Author(s):  
Rabinarayan Dhar ◽  
Satya Prasanna Nayak

<p class="abstract"><strong>Background:</strong> Many drugs have been used for postoperative pain management which is a common and distressing symptom after knee arthroscopy. But no single ideal intra-articular drug has been found. This study was done to assess the efficacy of intra-articular dexmedetomidine and clonidine for postoperative pain relief in patients undergoing arthroscopic knee surgeries<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> Fifty  patients of American Society of Anaesthesiologists of  grade I/II, aged 20-70 years posted for arthroscopic knee surgery were randomly divided into groups I (clonidine group) and group II (dexmedetomidine group). 25 patients in group I received  1 µg/ kg of clonidine diluted to 20 ml in normal saline and group II patients received 1 µg/kg of dexmedetomidine diluted to 20 ml in normal saline via intra-articular route at the end of the surgery. Visual analogue score (VAS), time to give the first dose of analgesia and total dose of analgesic required in first 24 hours was evaluated in each group.<strong></strong></p><p class="abstract"><strong>Results:</strong> VAS score was lower and time to first analgesic requirement was greater in Group II in comparison to Group I which was statistically significant. Total dose of analgesic used in Group II patients was significantly less compared to patients in Group I which was statistically significant<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Intra-articular dexmedetomidine is more effective in providing prolonged postoperative analgesia after arthroscopic knee procedures and reduces the total dose of analgesic required postoperatively compared to clonidine<span lang="EN-IN">.</span></p><p class="abstract"> </p>

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lijun Shi ◽  
Haiyun Zhu ◽  
Jinhui Ma ◽  
Li-Li Shi ◽  
Fuqiang Gao ◽  
...  

Abstract Objective We aimed to evaluate the safety and efficacy of intra-articular (IA) magnesium (Mg) for postoperative pain relief after arthroscopic knee surgery. Methods We searched PubMed, Embase, Medline, Cochrane library, and Web of Science to identify randomized controlled trials that compared postoperative pain outcomes with or without IA Mg after knee arthroscopy. The primary outcomes were pain intensity at rest and with movement at different postoperative time points and cumulative opioid consumption within 24 h after surgery. Secondary outcomes included the time to first analgesic request and side effects. Results In total, 11 studies involving 677 participants met the eligibility criteria. Pain scores at rest and with movement 2, 4, 12, and 24 h after surgery were significantly lower, doses of supplementary opioid consumption were smaller, and the time to first analgesic requirement was longer in the IA Mg group compared with the control group. No significant difference was detected regarding adverse reactions between the groups. Conclusions Intra-articular magnesium is an effective and safe coadjuvant treatment for relieving postoperative pain intensity after arthroscopic knee surgery. Protocol registration at PROSPERO: CRD42020156403.


2016 ◽  
Vol 2016 ◽  
pp. 1-6
Author(s):  
Jairo Moyano ◽  
Maria García ◽  
Maria Caicedo

Background.Dexamethasone is sometimes used as a coanalgesic because of its anti-inflammatory properties.Objective. To evaluate opioid use, postoperative pain intensity, and side effects after a single dose of dexamethasone in patients undergoing arthroscopic knee surgery.Methods. In this randomized controlled study patients were randomized to receive either 10 mg of intravenous dexamethasone (DM group) or 0.9% normal saline (NS group) during the intraoperative period. Primary outcomes were pain intensity and total morphine and codeine use after surgery.Results. Seventy-eight patients were included in the study. The DM group showed statistically significant higher pain intensity at the fourth postoperative hour (DM: 3.96/10, standard deviation [SD] 0.54; NS: 2.46/10, SD 0.45;p=0.036). No statistically significant difference in total opioid use (morphine plus codeine) was identified with 15.9 (SD 1.97) codeine tablets used in DM group and 20 (SD 2.14) in NS group (p=0.25).Discussion. Pain intensity tended to decrease in both groups suggesting morphine as the main source of analgesia.Conclusions. Intravenous dexamethasone during the intraoperative period has no clinical impact on postoperative pain intensity during the first 48 h after arthroscopic knee surgery. This trial is registered withR000020892.


1999 ◽  
Vol 36 (4) ◽  
pp. 674
Author(s):  
Young Jae Kim ◽  
Seung Keon Lee ◽  
Soon Ho Cheong ◽  
Young Kyun Choe ◽  
Jin Woo Park ◽  
...  

1998 ◽  
Vol 89 (Supplement) ◽  
pp. 9A
Author(s):  
S S Reuben ◽  
N R Connelly ◽  
J Sklar ◽  
C S Gibson

2000 ◽  
Vol 17 (Supplement 19) ◽  
pp. 11
Author(s):  
Y. Gürkhan ◽  
L. Kiliçkan ◽  
S. Müezzinoğlu ◽  
H. Canatay ◽  
K. Toker

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