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Orthopaedic surgeans can use dexmedetomidine to reduce ropivacaine
used for anesthesia during total knee
replacement surgery.
The data from a study
published in Medical Science Monitor revealed that the use of perineural dexmedetomidine 1 μg/kg could be useful in
decreasing the median effective concentration of ropivacaine for the adductor
canal block.
Multimodal analgesic treatments
(i.e. adductor canal block plus local infiltration analgesia along with a block
of the interspace between popliteal artery and posterior aspect of the knee)
are widely used for total knee replacement. But, considerable amount of local
anesthetics used during these treatments can‘t be ignored.
This study by Chunguang Wang and collegues investigated if the amount of local
anesthetics could be reduced with the help of dexmedetomidine for this
interfascial plane block in
patients undergoing total knee replacement.
Overall, 54 patients planned for primary total knee replacement were assigned to group R or ropivacaine group and group RD or dexmedetomidine group. Initially, ropivacaine 0.5% which later varied depending on reaction of the preceding participant. Thereafter, the the median effective concentration was evaluated.
At 30 minutes following the adductor canal block and during improvement from general anesthesia, the Group R and Group RA had similar quadriceps strength. Median effective quantity of ropivacaine for adductor canal block was 0.29% in group RD, which was lower as observed in the group R (0.38%). To conclude, the effective concentration of local anesthic can be decreased with the help of dexmedetomidine.
Medical Science Monitor
Perineural Dexmedetomidine Reduces the Median Effective Concentration of Ropivacaine for Adductor Canal Block
Chunguang Wang et al.
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