Evaluation of analgesic efficacy of dexmedetomidine as adjuvant with ropivacaine in ultrasound-guided adductor canal block in patients following anterior cruciate ligament reconstruction surgeries

Abstract

Introduction: Local anaesthetic (LA) with highly selective alpha-2 agonist dexmedetomidine has not been evaluated in adductor canal block (ACB) for arthroscopic anterior cruciate ligament (ACL) reconstruction surgeries. The study evaluates postoperative analgesic effect of ropivacaine with adjuvant dexmedetomidine following postoperative ultrasound-guided ACB. Methods: 105 randomized subjects received ultrasound-guided ACB using 15\u2009mL of 0.5% ropivacaine, with 0.5\u2009µg\u2009kg−1 of dexmedetomidine administered perineurally (Group II), intravenously (Group III) or none (Group I). Primary outcome included 24\u2009hours’ total morphine consumption postoperatively. Secondary outcomes included haemodynamics and adverse effects. Results: The postoperative total morphine consumption was significantly reduced till 4\u2009hours in II 0.57\u2009mg (0.98 (0–3)) (p\u2009=\u20090.011) and up to 6\u2009hours in Group III 0.77\u2009mg (1.00 (0–4)) (p\u2009=\u20090.004) compared to Group I. The postoperative total morphine consumption was comparable at 24\u2009hours in Group III 3.57\u2009mg (1.73 (0–8)) and Group II 3.34\u2009mg (1.92 (07)) (p\u2009=\u20091.000). The visual analogue scale (VAS) scores were comparable in all the three groups at all the time intervals studied (p\u2009>\u20090.05). There were no adverse effects observed during the study. Conclusion: Use of perineural dexmedetomidine with LA for ACB in the postoperative period resulted in significant reduction in total morphine consumption in initial 4\u2009hours as compared to 6\u2009hours with intravenous (IV) dexmedetomidine.