Combined Intrathecal Dexmedetomidine and Adductor Canal Block for Analgesia After Total Knee Arthroplasty

Combined Intrathecal Dexmedetomidine and Adductor Canal Block for Analgesia After Total Knee Arthroplasty: A Randomized Controlled Trial

The aim of this work is to evaluate the effect of combined intrathecal dexmedetomidine and adductor canal block for analgesia after total knee arthroplasty (TKA).

Effective postoperative pain management is essential for improving patient outcomes following knee surgery, facilitating early mobilization, and reducing the risk of complications.

The adductor canal block (ACB) is a nerve block of Hunters canal, which includes the saphenous and vastus medialis nerves. Additionally, other sensory nerves, such as the femoral nerve, medial cutaneous nerve, and both the anterior branch and terminal end of the posterior branch of the obturator nerve to some extent as it enters the distal part of the canal are blocked by the ACB.

Dexmedetomidine (DXM) a highly selective α2 adrenergic agonist with sedative, anxiolytic, analgesic, sympatholytic and antihypertensive effects.

Inclusion Criteria:

• Age from 18 to 75 years.
• Both sexes.
• American Society of Anesthesiology (ASA) physical status I-II.
• Scheduled for total knee arthroplasty under spinal anesthesia.

Exclusion Criteria:

• Patients with neurological or intellectual disability.
• History of allergy to local anesthetics or dexmedetomidine .
• Infection at the injection site.
• Prolonged use of analgesic or sedative medications.
• Coagulation abnormalities.
• Pregnancy.
• Obesity [body mass index (BMI) > 30 kg/m2].