Comparison of Two Doses of Dexmedetomidine as Adjuvant to Ropivacaine in Ultrasound Guided Adductor Canal Block: Randomised Double-Blind Controlled Trial

Neha Amey Panse; Sameer Kulkarni; Utkarsha Pradeep Bhojane; Rushikesh Madhav Yelgudkar

doi:10.18502/aacc.v8i2.9150

Neha Amey Panse Department of Anesthesiology , Smt Kashibai Navale Medical College, Pune , Maharashtra, India.
Sameer Kulkarni Department of Anesthesiology , Smt Kashibai Navale Medical College, Pune , Maharashtra, India.
Utkarsha Pradeep Bhojane Department of Anesthesiology , Smt Kashibai Navale Medical College, Pune , Maharashtra, India.
Rushikesh Madhav Yelgudkar Department of Anesthesiology , Smt Kashibai Navale Medical College, Pune , Maharashtra, India.

DOI: https://doi.org/10.18502/aacc.v8i2.9150

Keywords: Adductor canal block; Arthroscopic ligament reconstructions knee surgeries; Dexmedetomidine; Local anesthetics; Ropivacaine; Ultrasound guided

Abstract

Background: Adjuvants to local anesthetics (LA) have proven to prolong the analgesic efficacy of Adductor canal block (ACB). The ACB when administered with lower dose of LA produces analgesia without loss of motor control of the thigh. Hence we studied the efficacy of two different doses of dexmedetomidine in ACB to prolong postoperative analgesia when used as adjuvant to ropivacaine.

Methods: Total of 90 patients between 18-65years undergoing arthroscopic ligament reconstructions surgeries of knee were randomized into three groups and given Ultrasound guided (USG) ACB. Group A - 0.2% Ropivacaine, Group B – 0.2% Ropivacaine plus Dexmedetomidine 0.50 mcg.kg^-1 and Group C- 0.2% Ropivacaine plus Dexmedetomidine 1 mcg.kg^-1. Primary aim of our intervention was to study the duration of post-operative analgesia and Secondary aim was to study the total dose of rescue analgesic required in 24hrs, success of early ambulation, level of patient satisfaction and any adverse effects.

Results: The duration of analgesia was found highest in Group C (1166 ±200mins) than Group A (420±100mins) and Group B (702± 150mins). The total dose of tramadol consumption in 24 hours was highest in Group A. The number of steps walked postoperatively after 24 hours and level of patient satisfaction was maximum with Group C.

Conclusion: Use of 1mcg.kg^-1 of dexmedetomidine as adjuvant to 0.2% ropivacaine in ACB after arthroscopic knee surgeries significantly prolongs the duration of postoperative analgesia, reducing the total requirement of rescue analgesic without causing any untoward effects and preserving quadriceps strength aiding in early ambulation and recovery.