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Efficacy of dexmedetomidine combined with ropivacaine on postoperative analgesia and delirium in elderly patients with total knee arthroplasty

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Abstract

This study aimed to investigate the impact of dexmedetomidine combined with ropivacaine on continuous femoral nerve block (CFNB) in postoperative analgesia and delirium in elderly patients with total knee arthroplasty (TKA). A total of 120 patients who undergone TKA were randomly assigned into group D + R (dexmedetomidine combined with ropivacaine) and group R (only ropivacaine), with 60 cases in each group. The pain scores at rest and exercise at 6 h, 12 h, 24 h, and 48 h postoperatively. The occurrence of delirium on Day 1, Day 2, and Day 3 postoperatively were measured, and the sleep quality was evaluated before surgery, the night of surgery, and 24 h postoperatively to observe the occurrence of postoperative complications. The Visual analogu scale (VAS) of group D + R at 12 h, 24 h, and 48 h postoperatively were lower than those of group R in both rest and exercise states. The incidence of postoperative delirium in group D + R was lower than that in group R on Day 1 and Day 2. Pittsburgh sleep quality index (PSQI) scores in group D + R were lower than those in group R. There was no significant difference in postoperative adverse reactions between the two groups. Dexmedetomidine combined with ropivacaine improves postoperative analgesia and sleep quality, and alleviates the occurrence of postoperative delirium in elderly patients with TKA.

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References

  1. Felson DT, Zhang Y (2015) An update on the epidemiology of knee and hip osteoarthritis with a view to prevention. Arthritis Rheum: Off J Am Coll Rheumatol 41(8):1343–1355

    Article  Google Scholar 

  2. Sensi L, Buzzi R, Giron F et al (2017) Patellofemoral function after total knee arthroplasty: gender-related differences. J Arthroplasty 26(8):1475–1480

    Article  Google Scholar 

  3. Bonica JC (2014) The management of pain, 2nd edn. Lea Febiger, Philadephia, pp 416–480

    Google Scholar 

  4. Scott JE, Mathias JL, Kneebone AC (2017) Postoperative cognitive dysfunction after total joint arthroplasty in the elderly: a meta-analysis. J Arthroplasty 29(2):261–267

    Article  Google Scholar 

  5. Lee MJ, Koo DJ, Choi YS et al (2018) Dexamethasone or dexmedetomidine as local anesthetic adjuvants for ultrasound-guided axillary brachial plexus blocks with nerve stimulation. Korean J Pain 29(1):911–918

    Google Scholar 

  6. Marhofer P, Brummett CM (2016) Safety and efficiency of dexmedetomidine as adjuvant to local anesthetics. Curr Opin Anaesthesiol 29(5):632–637

    Article  CAS  PubMed  Google Scholar 

  7. Abdallah FW, Brull R (2013) Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block: a systemic review and meta-analysis. Br J Anaesth 110(3):915–925

    Article  CAS  PubMed  Google Scholar 

  8. Conti G, Ranieri VM, Costs R et al (2016) Effects of dexmedetomidine and propofol on patient-ventilator interaction in difficult-to-wean, mechanically ventilated patients: a prospective, open-label, randomised, multicentre study. Crit Care 20(1):206

    Article  PubMed  PubMed Central  Google Scholar 

  9. Abo-Zeid MA, Bakrey SA, Elbadrawy RE (2023) Intravenous versus perineural dexmedetomidine as adjuvant in adductor canal block for total knee arthroplasty. Korean J Anesthesiol. https://doi.org/10.4097/kja.22579

    Article  Google Scholar 

  10. Xu T, Chen X, Li X et al (2022) Effect of dexmedetomidine-assisted ultrasound-guided lower extremity nerve block on postoperative cognitive function in elderly patients undergoing hip surgery. Am J Transl Res 14(11):7977–7984

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Wang Y, Han R, Zuo Z (2016) Dexmedetomidine post-treatment induces neuroprotection via activation of extracellular signal-regulated kinase in rats with subarachnoid haemorrhage. Br J Anaesth 116(3):384–392

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Akshara P, Govindan DK, Govindasamy J et al (2022) Comparing different doses of dexmedetomidine combined with ropivacaine for ultrasound-guided supraclavicular brachial plexus block in upper limb surgeries - A prospective randomized controlled trial. Anesth Essays Res 16(1):94–97

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Brummett CM, Hong EK, Janda AM et al (2015) Perineural dexmedetomidine added to ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpolarization-activated cation current. Anesthesiol: J Am Soc Anesthesiol 115(4):836–843

    Article  Google Scholar 

  14. Keplinger M, Marhofer P, Kettner SC et al (2015) A pharmacodynamic evaluation of dexmedetomidine as an additive drug to ropivacaine for peripheral nerve blockade: a randomised, triple-blind, controlled study in volunteers. Eur J Anaesthesiol 32(11):790–796

    Article  CAS  PubMed  Google Scholar 

  15. Bajwa SJS, Bajwa SK, Kaur J et al (2017) Dexmedetomidine and clonidine in epidural anaesthesia: a comparative evaluation. Indian J Anaesth 3(4):475–483

    Google Scholar 

  16. Ebert TJ, Hall JE, Barney JA et al (2015) The effects of increasing plasma concentrations of dexmedetomidine in humans. Anesthesiology 93(2):382–394

    Article  Google Scholar 

  17. Kucuk A, Yaylak F, Cavunt-Bayraktar A et al (2014) The protective effects of dexmedetomidine on hepatic ischemia reperfusion injury. Bratisl Lek Listy 115(11):680–684

    CAS  PubMed  Google Scholar 

  18. Xu L, Hu Z, Shen J et al (2014) Does dexmedetomidine have a cardiac protective effect during non-cardiac surgery A randomised controlled trial. Clin Exp Pharmacol Physiol 41(11):879–883

    Article  CAS  PubMed  Google Scholar 

  19. Dalkilic N, Tuncer S, Burat I (2015) Dexmedetomidine augments the effect oflidocaine: power spectrum and nerve conduction velocity distribution study. Anesthesiology 15(1):24–31

    PubMed  PubMed Central  Google Scholar 

  20. Wang YM (2017) The clinical advance in dexmedetomidine. Chin J TCM WM Crit Care 21(2):152–154

    Google Scholar 

  21. Brummett CM, Norat MA, Palmisano JM et al (2016) Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in the rat. Anesthesiology 109(3):502–511

    Article  Google Scholar 

  22. Brummett CM, Padda AK, Amodeo FS et al (2017) Perineural dexmedetomidine added to ropivacaine causes a dose-dependent increase in the duration of thermal antinociception in sciatic nerve block in rat. Anesthesiol: J Am Soc Anesthesiol 111(5):1111–1119

    Article  Google Scholar 

  23. Su X, Wang DX (2018) Improve postoperative sleep: what can we do? Curr Opin Anaesthesiol 31(1):83–88

    Article  PubMed  Google Scholar 

  24. Su X, Meng Z-T, Wu X-H et al (2017) Dexmedetomidine for prevention of delirium in elderly patients after non-cardiac surgery: a randomised, double-blind, placebo-controlled trial. The Lancet 388(10054):1893–1902

    Article  Google Scholar 

  25. Gurajala I, Thipparampall AK, Durga P et al (2015) Effect of perineural dexmedetomidine on the quality of supraclavicular brachial plexus block with 0.5% ropivacaine and its interaction with general anaesthesia. Indian J Anaesth 59(2):89

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Mohta M, Kalra B, Sethi AK et al (2016) Efficacy of dexmedetomidine as an adjuvant in paravertebral block in breast cancer surgery. J Anesth 30(2):252–260

    Article  PubMed  Google Scholar 

  27. Tang C, Xia Z (2017) Dexmedetomidine in perioperative acute pain management: a non-opioid adjuvant analgesic. J Pain Res 10:345–359

    Article  Google Scholar 

  28. Yu JM, Sun H, Wu C et al (2016) The analgesic effect of ropivacaine combined with dexmedetomidine for incision infiltration after laparoscopic cholecystectomy. Surgi Laparosc Endosc Percutaneous Tech 26(6):449–454

    Article  Google Scholar 

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Author notes

  1. Zhen-Hai Ye and Yan Li contributed equally to this work.

Authors and Affiliations

  1. Department of Anesthesiology, People’s Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University Affiliated People’s Hospital of Ningxia Hui Autonomous Region, Third Clinical Medical College of Ningxia Medical University, No. 301 Zhengyuan North Street, Jinfeng District, Yinchuan, 750002, Ningxia, China

    Zhen-Hai Ye, Yan Li, Xi-Ping Wu, Zhi Yu, Zeng-Rui Ma, Ke-Rong Hai & Qing-Shan Ye

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  1. Zhen-Hai Ye
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  2. Yan Li
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  4. Zhi Yu
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Contributions

Conception and design of the research: Zhenhai Ye, Yan Li Acquisition of data: Xiping Wu, Zhi Yu Analysis and interpretation of the data: Zengrui Ma, Zhi Yu Statistical analysis: Kerong Hai, Zengrui Ma, Xiping Wu Writing of the manuscript: Zhenhai Ye, Yan Li, Qingshan Ye Critical revision of the manuscript for intellectual content: Kerong Hai, Qingshan Ye All authors read and approved the final draft.

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Correspondence to Qing-Shan Ye.

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Ye, ZH., Li, Y., Wu, XP. et al. Efficacy of dexmedetomidine combined with ropivacaine on postoperative analgesia and delirium in elderly patients with total knee arthroplasty. J Robotic Surg 18, 35 (2024). https://doi.org/10.1007/s11701-023-01773-x

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