Dexmedetomidine versus Dexamethasone as Adjuvant to Bupivacaine in Fascia Iliaca Block in Knee Arthroscopy for Postoperative Pain

Abstract

Abstract Background Knee arthroscopy is one of the most frequently performed interventions in orthopedic surgery that is commonly performed on a day-case basis. It allows the diagnosis and management of a wide range of knee problems without making a large incision, thus decreasing soft tissue trauma. However, postoperative pain is a common upsetting symptom following arthroscopic knee surgery that if inadequately treated, leads to prolonged duration of the functional rehabilitation of the knee, recovery time and the length of hospital stay thus a significant increase in the medical care costs. Aim of the Work To compare the adjuvant effect of adding dexmedetomidine and/or dexamethasone to bupivacaine while using facsia iliaca block for knee arthroscopy and their efficacy in achieving postoperative analgesia. Patients and Methods The type of study was a prospective double – blinded randomized controlled Trial conducted in Ain Shams University hospitals, Cairo, Egypt at 6 months. Patients aged 20 to 60 years scheduled for elective knee arthroscopy under spinal anesthesia were included to receive FICB. Results In general, there was no significant difference between the three study groups regarding general patient characteristics as well as operative time. That ensured proper randomization conducted between our study groups. Additionally, that should nullify any bias that may have skewed the results in favor of one group rather than another one. There was statistically significant difference between groups according to heart rate from after 2hrs to after 24hrs this was also observed while measuring the systolic blood pressure and diastolic blood pressure but there was no significant difference between group B and C. Conclusion Our study shows that adding Dexmedetomidine and/or Dexamethasone (8mg) to Bupivacaine for FICB significantly prolonged the duration of block and decreased the requirement of rescue analgesics as compared to patients who received Bupivacaine alone. FICB is relatively easy and safe to perform. In our study we did not encounter any complication while doing the procedures and also by adding dexmedetomidine and/or dexamethasone (8mg).