Surgical trauma induces activation of the sympathetic nervous system and triggers a systemic inflammatory response that may adversely affect postoperative recovery. Dexmedetomidine, a highly selective α2-adrenoceptor agonist, has been proposed as a pharmacological neuromodulatory strategy capable of attenuating sympathetic activation and modulating neuroimmune interactions during the perioperative period. However, the extent to which intravenous dexmedetomidine influences perioperative inflammatory biomarkers and clinical recovery in patients undergoing total hip arthroplasty under regional anesthesia remains unclear.
This prospective, randomized, double-blind, placebo-controlled trial aims to evaluate the effects of two doses of intravenous dexmedetomidine administered during spinal anesthesia combined with ultrasound-guided pericapsular nerve group (PENG) block on autonomic regulation, systemic inflammatory response, postoperative pain, opioid consumption, and quality of recovery following elective primary total hip arthroplasty.
Inclusion Criteria:
Exclusion Criteria:
mreysner@ump.edu.pl
Participants will receive intravenous placebo (0.9% saline) administered according to the study protocol during elective primary total hip arthroplasty performed under spinal anesthesia combined with ultrasound-guided Pericapsular Nerve Group (PENG) block. All participants will receive identical perioperative management and multimodal analgesia. Intravenous placebo is the only study intervention differing between groups.
Participants will receive low-dose intravenous dexmedetomidine administered according to the study protocol during elective primary total hip arthroplasty performed under spinal anesthesia combined with ultrasound-guided Pericapsular Nerve Group (PENG) block. All participants will receive identical perioperative management and multimodal analgesia. Intravenous dexmedetomidine dose is the only study intervention differing between groups.
Participants will receive high-dose intravenous dexmedetomidine administered according to the study protocol during elective primary total hip arthroplasty performed under spinal anesthesia combined with ultrasound-guided Pericapsular Nerve Group (PENG) block. All participants will receive identical perioperative management and multimodal analgesia. Intravenous dexmedetomidine dose is the only study intervention differing between groups.
Dexamethasone vs. Dexmedetomidine for ESPB in Pain Management After Hip Arthroplasty
The Effect of Dexamethasone Administration Route on Pain and Inflammatory Response in PENG Block for Total Hip Arthroplasty
Postoperative Recovery in Elderly Patients Undergoing Hip Hemi-arthroplasty