MedPath

Comparison of Intrathecal Dexmedetomidine Versus Fentanyl as Adjuvants to Bupivacaine on Post-operative Urinary Retention in Knee Joint Arthroscopic Surgeries

Phase 4
Completed
Conditions
Post-Op Complication
Interventions
Drug: Bupivacaine-Fentanyl group
Registration Number
NCT05596552
Lead Sponsor
Ain Shams University
Brief Summary

The aim of this study was to assess the effect of intrathecally injected 5 µg dexmedetomidine or 25 µg fentanyl as adjuvants to bupivacaine in low dose spinal anesthesia for unilateral arthroscopic knee surgeries, on post-operative urinary retention (POUR), time needed to reach sensory block at the tenth thoracic dermatome (T10), the maximum sensory level achieved, the onset of motor block, the intra-operative fluids given, the duration of sensory and motor blocks, time to micturition or insertion of an intermittent urinary catheter and the number of patients who needed an indwelling (Foley's) catheter. Seventy patients, ASA physical status I or II, from 21 to 50 years old, scheduled to undergo unilateral arthroscopic knee surgeries under spinal anesthesia, were randomly divided into two equal groups; the Bupivacaine- Dexmedetomidine group (BD) patients and the Bupivacaine-Fentanyl group (BF) patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
70
Inclusion Criteria
  • ASA physical status I and II
  • aged 21-50 years
  • scheduled to undergo unilateral arthroscopic knee surgeries under spinal anesthesia
Exclusion Criteria
  • Patients' refusal
  • contraindications to spinal anesthesia
  • patients with coagulopathy
  • infection at the lumbar region
  • pre-existing neurological deficits in the lower limbs
  • known allergy to any of the study drugs
  • urinary incontinence
  • cysto-ureteric reflux
  • patients with congestive heart failure
  • patients with dysrhythmia
  • patients with heart block
  • diabetic patients
  • patients on α2-adrenergic receptors antagonists
  • calcium channel blockers

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Bupivacaine-Dexmedetomidine grouphyperbaric bupivacaine and dexmedetomidine-
Bupivacaine-Fentanyl groupBupivacaine-Fentanyl group-
Primary Outcome Measures
NameTimeMethod
Post-operative urinary retention3 hours

Ultrasound assessment of the urinary bladder volume was done at the 3rd post-operative hour, a bladder volume of \>700 ml with no ability to void confirmed the presence of urinary retention

Secondary Outcome Measures
NameTimeMethod
Time to micturition or insertion of an intermittent urinary catheter6 hours

The time from completion of intrathecal injection of the study drug till voiding or insertion of an in-out catheter

Maximum sensory level achieved30 minutes

Sensory level assessment by loss of sensation to pinprick every 2 minutes, until the highest level had stabilized for four consecutive tests

Number of patients who needed an indwelling (Foley's) catheter6 hours

After 6 post-operative hours, if the patient wasn't able to void an indwelling (Foley's) catheter was then placed

Time to reach sensory block at T1030 minutes

The time from completion of intrathecal injection of the study drug till loss of sensation to pin prick at T10 on the operative side, assessed every 2 minutes.

Duration of sensory block6 hours

he time from completion of intrathecal injection of the study drug till regression to the third sacral dermatome (S3) level

The onset of motor block30 minutes

The time from completion of intrathecal injection of the study drug till having a modified Bromage score = 1 or more

Intra-operative fluids given3 hours

The volume of IV Ringer's solution given to each patient according to the fluid chart

Duration of motor block6 hours

The time from completion of intrathecal injection of the study drug till complete recovery of the motor function (MBS = 0), by asking the patient to flex the hip, knee and ankle joints, in the PACU, then every 15 minutes in the ward

Trial Locations

Locations (1)

Faculty of Medicine

🇪🇬

Cairo, Egypt

© Copyright 2025. All Rights Reserved by MedPath