Adding dexmedetomidine to ropivacaine for femoral nerve block inhibits local inflammatory response

作者：Li, Jing^*; Wang, Hanghui; Dong, Buhuai; Ma, Jianbing; Wu, Xucai

来源：Minerva Anestesiologica, 2017, 83(6): 590-597.

DOI：10.23736/S0375-9393.17.11430-6

• Dexmedetomidine
• Inflammation
• Knee replacement arthroplasty
• Nerve block
• Dinoprostone
• Interleukin-6

BACKGROUND: Peripheral nerve block has an anti-inflammatory effect that is confirmed in animal studies, while inconclusive in human studies. Dexmedetomidine (DEX), a highly selective alpha 2-adenoceptor agonist, has a potent anti-inflammatory effect. The aim of this study was to evaluate the effect of DEX added to ropivacaine for femoral nerve block (FNB) on local inflammatory response after total knee arthroplasty (TKA).
METHODS: Sixty patients scheduled for TKA were randomized into two equal groups in a prospective randomized study. They were all treated with FNB preoperatively. In group R, 20 mL of 0.5% ropivacaine were injected for the block; in group RD, 20 mL of 0.5% ropivacaine plus 1 mu g/kg DEX were administered. Visual Analog Scale (VAS), the circumference of the operated knee, and the concentration of interleukin-6 (IL-6) and prostaglandin E2 (PGE2) in joint fluid were evaluated. Adverse events such as hypotension, bradycardia and hypoxia were recorded.
RESULTS: VAS was lower in group RD for 12 to 48 hours after surgery (P<0.03). Knee circumference was smaller in group RD at each time point after surgery (P<0.05). PGE2 in joint fluid in group RD was lower at 6, 12, 24, and 48 hours after surgery (P<0.02), IL-6 was lower at 12, 24, and 48 hours after surgery (P<0.03). No adverse events were observed.
CONCLUSIONS: Adding 1 mu g/kg dexmedetomidine to ropivacaine for femoral nerve block had a significantly inhibitory effect on local inflammatory response and showed superior postoperative pain control to ropivacaine alone after TKA.

• 出版日期2017-6
• 单位西安交通大学