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Background and Aims One of the sites of dexmedetomidine action is substantia gelatinosa, which is responsible for analgesia. The aim of our study is to investigate how effective may be dexmedetomidine for PENG block in postoperative analgesia and mobilization after such a major surgery, as total hip replacement, conducted with robotic device.
Methods Prior to surgery, demographic features, VAS scores at rest and during mobilization and TUG test duration were recorded. By the termination of surgery, 15 cc%0.5 bupivacaine, 5 cc%2 lidocaine and 100 mcg dexmedetomidine was used for PENG block under USG guidance. All patients received intravenous PCA containing 300 mg tramadol. In the postoperative unit VAS score, vital signs and rescue morphine doses were recorded every 5 minutes of total 30 minutes stay. After discharge from the postoperative unit, time to first PCA bolus dose, hourly VAS score, rescue morphine and tramadol doses, TUG test duration at 24th and 48th hours, total opioid dose and patient satisfaction at discharge were recorded.
Results Adding dexmedetomidine to PENG block analgesic solution nearly prevents postoperative rescue opioid doses and bolus PCA doses. Postoperative VAS scores are extremely low , which offers painless early mobilization and patient comfort.
Conclusions Dexmedetomidine efficacy in prolonging peripheral nerve block analgesia, reducing block site inflammation and postoperative opioid consumption has been described in literature, generally in animal studies, case reports and and volunteer studies. Our case series confirm these data and, at the same time, indicate on postoperative opioid consumption reduce, painless mobilization and high patient satisfaction.