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Dexmedetomidine as an Intrathecal Adjuvant to Hyperbaric Bupivacaine for Postoperative Analgesia in Patients Undergoing Arthroscopic Anterior Cruciate Ligament Reconstruction Surgeries

Not Applicable
Completed
Conditions
Dexmedetomidine
Intrathecal
Adjuvant
Hyperbaric Bupivacaine
Analgesia
Arthroscopic Anterior Cruciate Ligament Reconstruction
Interventions
Registration Number
NCT06667024
Lead Sponsor
Tanta University
Brief Summary

This study aimed to evaluate the effect of adding low doses of dexmedetomidine to hyperbaric bupivacaine during spinal anesthesia on post operative analgesia characteristics in Arthroscopic Anterior Cruciate Ligament Reconstruction Surgeries

Detailed Description

The anterior cruciate ligament (ACL) is injured frequently during sports participation. Arthroscopic evaluation of patients with acute traumatic hemarthrosis of the knee has repeatedly demonstrated a 60% to 70% incidence of ACL injury.

Postoperative pain should be effectively treated because it represents an important component of postoperative recovery. Effective treatment serves to blunt autonomic, somatic, and endocrine reflexes with a resultant potential decrease in perioperative morbidity.

Dexmedetomidine is a highly selective α2-adrenergic agonist that has been used for premedication and as an adjunct to general anesthesia. It reduces opioid and inhalational anesthetics requirements.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
64
Inclusion Criteria
  • Aged from 21 to 50 years.
  • Both genders.
  • American society of anesthesiologists (ASA) physical status I and II.
  • Patients scheduled for arthroscopic anterior cruciate ligament reconstruction surgeries under spinal anesthesia.
Exclusion Criteria
  • Patient refusal.
  • Body Mass Index (BMI) more than 40 kg/m2.
  • Patients who were taking analgesics for chronic pain on opioid therapy or have a history of drug abuse.
  • Uncooperative patient.
  • Patients with coagulation disorders.
  • History of local anesthetics allergy.
  • Infection at the needle puncture site.
  • Patients with significant respiratory, cardiac, renal or hepatic disorders

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Control groupHyperbaric bupivacainePatients received the standard spinal anesthesia with 0.5% 3 ml according to the patient hyperbaric bupivacaine only.
Dexmedetomidine (study) groupDexmedetomidine and Hyperbaric bupivacainePatients received dexmedetomidine 4 μg and 0.5% (3-4 ml according to the patient's height) hyperbaric bupivacaine.
Primary Outcome Measures
NameTimeMethod
Total morphine consumption24 hours postoperatively

The rescue analgesia was morphine IV bolus of 3 mg with when VAS \> 30. Total morphine consumption in the first 24 hours postoperatively was documented.

Secondary Outcome Measures
NameTimeMethod
Time to first rescue analgesia request24 hours postoperatively

Time to the first rescue analgesia (time from end of surgery to first dose of morphine administrated) was recorded

Degree of pain24 hours postoperatively

Degree of pain was assessed using Visual Analogue Scale (VAS). VAS (0 represents "no pain" while 100 represents "the worst pain imaginable"). VAS was assessed at PACU, 1, 2, 4, 8, 12, 18, 24 hours postoperatively.

Duration of motor blockIntraoperatively

Duration of motor block starting from the time when the Bromage score 3 after spinal anesthesia until the time when the Bromage score was 0 postoperative.

Patient satisfaction24 hours postoperatively

Patients' satisfaction was measured 24 hours postoperative using a five-point Likert scale consisting of:

1: Very dissatisfied, 2: Dissatisfied, 3: Unsure, 4: Satisfied, 5: Very satisfied

Incidence of side effects24 hours postoperatively

Incidence of side effects such as Hypotension, Bradycardia, Shivering, nausea, and vomiting) were recorded.

Trial Locations

Locations (1)

Tanta University

🇪🇬

Tanta, El-Gharbia, Egypt

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