Comparative Study of Intra-articular Dexmedetomidine Versus Ketamine as an Adjuvant Analgesic after Arthroscopy

Bhaarat Maheshwari, Ronakkumar Patel, Namrata Kapadiya, Meet A. Moradiya
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Abstract

Abstract Background: The primary aim of this study was to evaluate the analgesic effect and safety of intra-articular Dexmedetomidine versus Ketamine in patients undergoing knee arthroscopic surgeries. Material and Methods: A total of 100 patients were allocated into two equal groups (n= 50 in each group) using random numbers, in an allocation ratio of 1:1. Syringes were labelled either D (dexmedetomidine) or K (ketamine) and study drugs were injected via intra-articular route after completion of knee arthroscopy. Analgesic effect of study drugs was compared using VAS score at 6 hrs, 12 hrs and 24 hrs. Safety of study drugs was compared using mean HR, mean BP and adverse events observed. Results: Lower VAS score, increased time for first rescue analgesic requirement and decreased need for postoperative analgesics were observed in the dexmedetomidine group as compared to ketamine group. Mean HR and Mean BP were lower in patients receiving dexmedetomine compared to those receiving ketamine. Hypotension was detected in 2 patients receiving dexmedetomedine while 1 patient on ketamine developed delirium. Conclusion: Intra-articular use of dexmedetomidine is superior to ketamine for post-operative analgesia without significant adverse effects. Key words: Knee arthroscopy, Intra-articular Dexmedetomidine, Intra-articular Ketamine
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关节镜术后关节内右美托咪定与氯胺酮辅助镇痛的比较研究
摘要背景:本研究的主要目的是评价右美托咪定与氯胺酮在膝关节镜手术患者关节内的镇痛效果和安全性。材料与方法:将100例患者随机分为两组,每组50例,随机编号,分配比例为1:1。注射器标记为D(右美托咪定)或K(氯胺酮),膝关节镜检查完成后通过关节内途径注射研究药物。采用6小时、12小时、24小时的VAS评分比较研究药物的镇痛效果。用平均HR、平均血压和观察到的不良事件比较研究药物的安全性。结果:与氯胺酮组相比,右美托咪定组VAS评分较低,首次救援镇痛需求时间增加,术后镇痛需求减少。右美托明组患者的平均HR和平均血压低于氯胺酮组。右美托美定组2例出现低血压,氯胺酮组1例出现谵妄。结论:右美托咪定关节内应用于术后镇痛优于氯胺酮,且无明显不良反应。关键词:膝关节镜,右美托咪定,氯胺酮
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