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Randomized Controlled Trial
. 2023 Dec 6;23(1):400.
doi: 10.1186/s12871-023-02361-0.

Ultrasound-guided dexmedetomidine combination with modified high fascia iliaca compartment block for arthroscopic knee surgery: what is the optimal dose of dexmedetomidine?

An Chen  1 , Wanqing Duan  1 , Ruijinlin Hao  1 , Chen Wang  1 , Xingguo Xu  2
Affiliations
Randomized Controlled Trial

Ultrasound-guided dexmedetomidine combination with modified high fascia iliaca compartment block for arthroscopic knee surgery: what is the optimal dose of dexmedetomidine?

An Chen et al. BMC Anesthesiol. .

Erratum in

Abstract

Background: Total knee arthroplasty (TKA) is a common orthopedic procedure for end-stage knee osteoarthritis. Although effective in relieving pain and improving function, postoperative pain is still a common and distressing problem for many patients. This study aims to investigate efficacy of combined administration of dexmedetomidine and modified high fascia iliaca compartment block (H-FICB) in managing acute and chronic pain after TKA, as well as to identify the optimal dosage of dexmedetomidine.

Methods: A double-blind, randomized controlled trial was conducted to evaluate the effects of dexmedetomidine in patients undergoing TKA. A total of 96 patients undergoing TKA were randomly assigned to one of three groups, were treated with different doses of dexmedetomidine All groups received H-FIB. Pain scores, opioid consumption, side effects, and quality of life were recorded 48 h postoperatively.

Results: The intraoperative consumption of remifentanil and propofol in Group Db was significantly reduced compared with that in Group D0 and Da (P < 0.05). Compared with D0 and Da group, Db group had the lowest number of rescue analgesia, analgesia time and morphine accumulative dosage 48 h after operation (P < 0.05). The Db group had the lowest scores on the numerical rating scale at rest (P < 0.05) and during movement (P < 0.01), followed by the Da group and then the D0 group. Additionally, the incidence of nausea and vomiting was significantly reduced in the Db group (P < 0.05). Furthermore, the Db group had the lowest incidence of chronic pain (P < 0.05).

Discussion: In comparison to the other two groups, the administration of combined dexmedetomidine and H-FIB resulted in a significant reduction in pain scores, opioid consumption, and side effects. The optimal dosage of dexmedetomidine was determined to be 1 μg/kg, which provided the most favorable pain relief with minimal adverse effects.

Keywords: Modified high fascia iliaca compartment block; Postoperative chronic pain; Total knee arthroplasty.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
A flow diagram of inclusion and exclusion criteria according to the CONSORT (Consolidated Standards of Reporting Trials) statement
Fig. 2
Fig. 2
(A) NRS.R scores in the three groups at different postoperative periods. A line graph represents the results. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001 compared with Group D0. (B) NRS.M scores in the three groups at different postoperative periods. A line graph represents the results. *P < 0.05, **P < 0.01,***P < 0.001,****P < 0.0001 compared with Group D0 Abbreviation: NRS.R, Numeric Rating Scale of Rest; NRS, Numeric Rating Scale of Movement
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