Abstract
Background: Various degrees of pain is seen in the post-operative period following almost every arthroscopic knee surgery. The reason behind this pain is due to the irritation that occurs to the nerve endings that are found free in the synovium of the knee. Hence, to make this difficult period pain free various analgesics are given to the patient. They are given through various routes and they may be given as sole analgesics or in combination. One such routes used is the intra-articular route in which analgesics are given intra-articularly for post -operative analgesia. Dexmedetomidine is a drug which can be used the aforementioned route. The main of this study is to evaluate the effectiveness of Intra-articular Dexmedetomidine as an adjuvant to Intra-articular Bupivacaine.
 Aim: This study aims to compare Intra-articular Bupivacaine vs Bupivacaine and Dexmedetomidine for prolonging post-operative analgesia following knee arthroscopy surgery.
 Objectives: The primary objective is to assess the duration of postoperative analgesia produced by Dexmedetomidine when used as an adjuvant to Intra-articular Bupivacaine after arthroscopic knee surgeries. The secondary objectives are to evaluate Dexmedetomidine as an adjuvant to Intra-articular Bupivacaine, with respect to:
 
 Quality of analgesia,
 Number of doses of rescue analgesic required during study period,
 Systemic/Local side effects.
 
 Methods: 60 patients within the age group 20-60 undergoing arthroscopic knee surgeries will be enrolled for the study. Following the completion of surgery, patients allotted to Group B will receive 19ml of Intra-articular Bupivacaine with 1ml of normal saline and patients allotted to Group D will receive 19 ml of Intra-articular Bupivacaine with 1mcg/kg Dexmedetomidine. Post-operative analgesia will be monitored using VAS and the requirement of rescue analgesics in both groups will be noted down and compared.
 Expected Outcomes: The VAS and total requirement of rescue analgesics is expected to be less in Group D with minimal/no side effects.
Highlights
2.1 Cardiovascular EffectsThe role of the modern anesthetist has evolved from providing the patient with intra-operative care to providing all round care
The primary objective is to assess the duration of postoperative analgesia produced by Dexmedetomidine when used as an adjuvant to Intra-articular Bupivacaine after arthroscopic knee surgeries
Dexmedetomidine administered as an adjuvant with Intra-articular Bupivacaine at the end of arthroscopic knee surgeries may be effective in prolonging the duration of postoperative analgesia without significant side effects
Summary
The role of the modern anesthetist has evolved from providing the patient with intra-operative care to providing all round care. The period immediately following surgery and pain management is an integral part of the treatment plan of the patient. Efficiently managing pain in the post-operative period is as crucial as pain management in the intraoperative period. An anesthetist must take into account that post-operative pain is not just due to tissue injury, but it is a culmination of various neurophysiological interactions. Operative [1] analgesia becomes much difficult and the ideal pain management is still elusive. The Joint Commission for Accreditation of Health Organization insists on the usage of a numerical pain scale periodically and use it as a criteria for discharge.
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