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Abstract
Background and Aims The aim of the study was to evaluate the efficacy and safety of adjuvants like dexamethasone. Buprenorphine and dexmedetomidine added ropivacaine 0.2% in adductor canal block for early postoperative pain management in patients undergoing total knee replacement.
Methods In our study 96 patients of ASA Iand II aged 45–75 years scheduled for unilateral TKR were recruited into the study. They were randomized into 3 groups.
Patients were given drugs as follows:
Group A : dexamethasone 8mg added to 20 ml 0.2% Ropivacaine.
Group B: Buprenorphine 0.3mg added to 20 ml 0.2% Ropivacaine
Group C: dexmedetomidine 1mcg/kg added to 20 ml 0.2% Ropivacine
Primary outcome was the measurement pain intensity based on VAS score upto 30 hrs postoperatively also measured the total duration of analgesia by each adjuvants, rescue analgesia (opioid consumption) ,quadriceps muscle weakness.
Results The patient characteristics and block success were comparable among the three groups. Group A patients had the least VAS score among the three groups.Group A had the longest duration of analgesia ( group A 20.30±2.151 ,group B 17.95±2.057 and group C 14.67±1.446) the range of movement was also better with Goup A compared to group B and group C which was stastically significant (p<0.001).
Conclusions From our study we concluded that all the three agents prolonged the duration of analgesia however the among the three agents dexamethasone had increased the effective analgesia time to a better extend compared to buprenorphine and dexmedetomidine. Furthermore Early mobilization was better with dexamethasone group compared with better range of movement.