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Dexmedetomidine versus tramadol as adjuvant to bupivacaine in intra-articular injection after knee arthroscopy: A prospective control randomized trial

Asmaa Fawzy Amer, MD, Laila Ahmed Al-Ahwal, MD

Abstract


Study objective: Evaluating the time to the first request of rescue analgesic after adding either dexmedetomidine or tramadol to intra-articular bupivacaine.

Design: A prospective, randomized, control, double-blinded study.

Setting: Operating room at Tanta University Hospital.

Patients: Sixty adult patients were enrolled and scheduled for knee arthroscopic surgery.

Interventions: Post-operative intra-articular injection of dexmedetomidine 1 μg/kg or tramadol 100 mg compared with a control group receiving intra-articular bupivacaine alone.

Main outcome: The time to the first request of rescue analgesic, total consumption of analgesic, and post-operative numeric rating scale at 1, 3, 6, 9, 12, and 24 hours post-operatively.

Results: The time to the first request of analgesia was comparable between group D and group T with p value 0.84, but it was significantly shorter in group T and group D in comparison with group C, with p value 0.001 for both. Post-operative 24 hours morphine consumption was also comparable between group D and group T with p value 0.17, but it was significantly lower in group T and group D in comparison with group C, with p value 0.001 for both. There was also no significant difference in numeric rating scale between dexmedetomidine group and tramadol group over the 24 hours of the study, but numeric rating scale values were significantly higher in the control group. The incidence of nausea and vomiting was comparable among the three groups. All patients displayed a stable hemodynamic profile.

Conclusions: Adding either dexmedetomidine or tramadol as a single dose to intra-articular bupivacaine resulted in the prolongation of the time to the first request of analgesic and reduced the incidence of post-operative pain and post-operative morphine requirement, when compared with the groups receiving intraarticular bupivacaine alone.


Keywords


intra-articular injection, knee arthroscopy, dexmedetomidine, tramadol, bupivacaine

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References


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DOI: https://doi.org/10.5055/jom.2022.0709

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