Effect of adding dexmedetomidine to intra-articular levobupivacaine on postoperative pain following arthroscopic meniscus surgery: A prospective, double-blind, randomized, placebo- controlled, clinical trial

Abstract

Objective: The aim of this study was to determine the effect of adding dexmedetomidine to intra-articular levobupivacaine on postoperative pain levels and analgesic requirements following arthroscopic meniscectomy. Methods: A total of 60 American Society of Anesthesiologist physical status I-II patients, aged 20 to 62 years, and scheduled for arthroscopic partial meniscectomy under general anesthesia were included in this study. All the patients were randomly assigned to one of four groups (15 patients in each group): Group 1 (8 male, 7 female; mean age = 46.70 ± 13.13 years; 0.9% isotonic 20 ml), group 2 (7 male, 8 female; mean age = 42.60 ± 12.18 years; levobupivacaine 0.5 mg/kg plus 0.9% isotonic), group 3 (8 male, 7 female; mean age = 43.80 ± 12.63 years; 1μg/kg dexmedetomidine plus 0.9% isotonic), and group 4 (7 female, 8 male; mean age = 40.40 ± 11.79 years; levobupivacaine 0.5 mg/kg plus 1μg/kg dexmedetomidine and 0.9% isotonic). All medications were administered at the end of arthroscopic surgery. Pain levels were measured using a Visual Analogous Scale (VAS) and Verbal Rating Scale (VRS) at postoperative 1, 2, 4, 6, 12, and 24 hours. Results: VAS scores at rest were significantly lower in Group 4 at postoperative 1th, 2nd, 4th, 6th,12th, and 24th hours than in other groups. The time to take the first analgesic was significantly higher in Group4 (964 ± 288 min), and total analgesic consumption was significantly lower in Group 4 compared to those of other groups. Conclusion: Although administration of intra-articular dexmedetomidine alone may have a weaker effect than intra-articular levobupivacaine on postoperative pain relief after arthroscopic partial meniscectomy, adding dexmedetomidine to intra-articular levobupivacaine may increase the durationand quality of postoperative analgesia without any side effect