Comparative study of Ropivacaine alone versus Ropivacaine combined with Dexmedetomidine and Dexamethasone in ultrasound Guided Adductor canal Block for Postoperative Analgesia in unilateral Total Knee Arthroplasty

This study is a prospective randomized comparative study to evaluate the efficacy of 0.2 percent ropivacaine alone versus 0.2 percent ropivacaine combined with dexamethasone and dexmedetomidine in ultrasound guided adductor canal block for postoperative analgesia in patients undergoing unilateral total knee replacement surgery. The primary objective is to compare duration of postoperative analgesia between the two groups. Secondary objectives include comparison of postoperative pain scores, total rescue analgesic consumption in 24 hours, time to first rescue analgesia, and incidence of adverse effects. Patients will be randomly allocated into two groups. Group R will receive 0.2 percent ropivacaine and Group RD will receive 0.2 percent ropivacaine with dexamethasone and dexmedetomidine. Outcomes will be assessed during the first 24 hours postoperatively.