Analgesia of Ultrasound-guided Single-dose Adductor Canal Block with Dexmedetomidine Combined with Ropivacaine after Patella Fracture Surgery in Adults

Yue LU; Changming QIU; Yunli YANG; Zhiguo HUANG; Zhigui LI; Weiqing MA; Na LI

doi:10.12259/j.issn.2095-610X.S20220613

Volume 43 Issue 6

Jun. 2022

Turn off MathJax

Article Contents

Article Navigation > Journal of Kunming Medical University > 2022 > 43(6): 68-73

Yue LU, Changming QIU, Yunli YANG, Zhiguo HUANG, Zhigui LI, Weiqing MA, Na LI. Analgesia of Ultrasound-guided Single-dose Adductor Canal Block with Dexmedetomidine Combined with Ropivacaine after Patella Fracture Surgery in Adults[J]. Journal of Kunming Medical University, 2022, 43(6): 68-73. doi: 10.12259/j.issn.2095-610X.S20220613

Citation:

Yue LU, Changming QIU, Yunli YANG, Zhiguo HUANG, Zhigui LI, Weiqing MA, Na LI. Analgesia of Ultrasound-guided Single-dose Adductor Canal Block with Dexmedetomidine Combined with Ropivacaine after Patella Fracture Surgery in Adults[J]. Journal of Kunming Medical University, 2022, 43(6): 68-73. doi: 10.12259/j.issn.2095-610X.S20220613

Citation:

Yue LU, Changming QIU, Yunli YANG, Zhiguo HUANG, Zhigui LI, Weiqing MA, Na LI. Analgesia of Ultrasound-guided Single-dose Adductor Canal Block with Dexmedetomidine Combined with Ropivacaine after Patella Fracture Surgery in Adults[J]. Journal of Kunming Medical University, 2022, 43(6): 68-73. doi: 10.12259/j.issn.2095-610X.S20220613

PDF( 634 KB)

Analgesia of Ultrasound-guided Single-dose Adductor Canal Block with Dexmedetomidine Combined with Ropivacaine after Patella Fracture Surgery in Adults

doi: 10.12259/j.issn.2095-610X.S20220613

1.
Kunming Medical University，Kunming，Yunnan 650500
2.
Dept. of Anesthesiology，920th Hospital of Joint Logistics Support Force，Kunming Yunnan 650100，China

Received Date: 2022-02-26
Available Online: 2022-06-07
Publish Date: 2022-06-30

Abstract

Abstract

Objective To compare the analgesic effect between ultrasound-guided single-dose adductor canal block with dexmedetomidine combined with ropivacaine and continuous femoral nerve block with ropivacaine after patella fracture surgery. Methods 31 patients with patella fractures who underwent elective general anesthesia, with age ranging from 21 to 69, BMI ≤ 35 kg/m², ASA grading Ⅰ～Ⅲ, were randomly divided into two groups. Single-dose adductor canal block group who received 100 μg dexmedetomidine combined with 0.25% ropivacaine 50 mg （A group, n = 21）, and continuous femoral nerve block group who received 0.25% ropivacaine 250 mg （F group, n = 10）. The scores regarding analgesia, sedation, and muscle strength at 6, 8, 12, 24, 36 and 48 h after surgery were observed and compared between the two groups and the additional postoperative analgesia and adverse reactions were recorded. Results The analgesic effect, postoperative scores based on sedation and muscle strength were not statistically different between the two groups at various points during the observation period （P > 0.05）. Conclusion Single-dose adductor canal block with dexmedetomidine combined with ropivacaine can provide good analgesia after patella fracture surgery.
- Adductor canal nerve block,
- Dexmedetomidine,
- Ropivacaine,
- Patellar fracture,
- Analgesia,
- Ultralsound guidance

FullText(HTML)

References(28)

References

[1]	Marino J,Scuderi G,Dowling O,et al. Periarticular knee injection with liposomal bupivacaine and continuous femoral nerve block for postoperative pain management after total knee arthroplasty:A randomized controlled trial.[J]. J Arthroplasty,2019,34(3):495-500. doi: 10.1016/j.arth.2018.11.025
[2]	Yan Y L,Xiang R,Zhang L,et al. Application of continuous femoral nerve block in postoperative analgesia of the patellar fractures.[J]. Practical Journal of Clinical Medicine,2014,120(2):383-389.
[3]	Ilfeld B M,Duke K B,Donohue M C. The association between lower extremity continuous peripheral nerve blocks and patient falls after knee and hip arthroplasty.[J]. AnesthAnalg,2010,111(6):1552-1554.
[4]	Kwofie M K,Shastri U D,Gadsden J C,et al. The effects of ultrasound-guided adductor canal block versus femoral nerve block on quadriceps strength and fall risk:a blinded,randomized trial of volunteers.[J]. Reg Anesth Pain Med,2013,38(4):321-325. doi: 10.1097/AAP.0b013e318295df80
[5]	Lund J,Jenstrup M T,Jaeger P,et al. Continuous adductor-canal-blockade for adjuvant post-operative analgesia after major knee surgery:preliminary results.[J]. Acta Anaesthesiol Scand,2011,55(1):14-19. doi: 10.1111/j.1399-6576.2010.02333.x
[6]	Esmaoglu A,Yegenoglu F,Akin A,et al. Dexmedetomidine added to levobupivacaine prolongs axillary brachial plexus block[J]. AnesthAnalg,2010,111(6):1548-1551.
[7]	Fritsch G,Danninger T,Allerberger K,et al. Dexmedetomidine added to ropivacaine extends the duration of interscalene brachial plexus blocks for elective shoulder surgery when compared with ropivacaine alone:a single-center,prospective,triple-blind,randomized controlled trial.[J]. Reg Anesth Pain Med,2014,39(1):37-47. doi: 10.1097/AAP.0000000000000033
[8]	Chen J Y,Li N,Xu Y Q. Single shot adductor canal block for postoperative analgesia of pediatric patellar dislocation surgery:A case-series report[J]. Medicine (Baltimore),2015,94(48):2217.
[9]	Ilfeld Brian M. Continuous peripheral nerve blocks:An update of the published evidence and comparison with novel,alternative analgesic modalities[J]. AnesthAnalg,2017,124(1):308-335.
[10]	Olive D J,Barrington M J,Simone S A,et al. A randomised controlled trial comparing three analgesia regimens following total knee joint replacement:continuous femoral nerve block,intrathecal morphine or both.[J]. Anaesth Intensive Care,2015,43(4):454-460. doi: 10.1177/0310057X1504300406
[11]	Swank K R,Di Bartola A C,Everhart J S,et al. The effect of femoral nerve block on quadriceps strength in anterior cruciate ligament reconstruction:A systematic review[J]. Arthroscopy,2017,33(5):1082-1091. doi: 10.1016/j.arthro.2017.01.034
[12]	Smith J H,Belk J W,Kraeutler M J,et al. Adductor Canal Versus Femoral Nerve Block after Anterior Cruciate Ligament Reconstruction:A Systematic Review of Level I Randomized Controlled Trials Comparing Early Postoperative Pain,Opioid Requirements,and Quadriceps Strength.[J]. Arthroscopy,2020,36(7):1973-1980. doi: 10.1016/j.arthro.2020.03.040
[13]	Wasserstein D,Farlinger C,Brull R,et al. Advanced age,obesity and continuous femoral nerve blockade are independent risk factors for inpatient falls after primary total knee arthroplasty.[J]. J Arthroplasty.,2013,28(7):1121-1124. doi: 10.1016/j.arth.2012.08.018
[14]	Pelt C E,Anderson A W,Anderson M B,et al. Postoperative falls after total knee arthroplasty in patients with a femoral nerve catheter:can we reduce the incidence?[J]. Arthroplasty.,2014,29(6):1154-1157. doi: 10.1016/j.arth.2014.01.006
[15]	Wiegel M,Gottschaldt U,Hennebach R,et al. Complications and adverse effects associated with continuous peripheral nerve blocks in orthopedic patients[J]. Anesth Analg,2007,104(6):1578-1582.
[16]	Edwards M D,Bethea J P,Hunnicutt J L,et al. Effect of adductor canal block versus femoral nerve block on quadriceps strength,function,and postoperative pain after anterior cruciate ligament reconstruction:A systematic review of level 1 studies[J]. Am J Sports Med,2020,48(9):2305-2313. doi: 10.1177/0363546519883589
[17]	Kim D H,Lin Y,Goytizolo E A,et al. Adductor canal block versus femoral nerve block for total knee arthroplasty:a prospective,randomized,controlled trial.[J]. Anesthesiology,2014,120(3):540-550. doi: 10.1097/ALN.0000000000000119
[18]	Elkassabany N M,Antosh S,Ahmed M,et al. The Risk of Falls After Total Knee Arthroplasty with the Use of a Femoral Nerve Block Versus an Adductor Canal Block:A Double-Blinded Randomized Controlled Study.[J]. Anesth Analg,2016,122(5):1696-1703.
[19]	Li S,Zhou J,Li X,Teng X,et al. Analgesic Impact of Single-Shot Versus Continuous Femoral Nerve Block After Total Knee Arthroplasty:A Systematic Review and Meta-Analysis.[J]. Adv Ther,2020,37(2):671-685. doi: 10.1007/s12325-019-01194-z
[20]	Wang C,Chen Z,Ma X. Continuous adductor canal block is a better choice compared to single shot after primary total knee arthroplasty:A meta-analysis of randomized controlled trials[J]. Int J Surg,2019,72(3):16-24.
[21]	Canbek U,Akgun U,Aydogan N H,et al. Continuous adductor canal block following total knee arthroplasty provides a better analgesia compared to single shot:A prospective randomized controlled trial.[J]. Acta OrthopTraumatolTurc,2019,53(5):334-339.
[22]	Hussain N,Grzywacz V P,Ferreri C A,et al. Investigating the Efficacy of Dexmedetomidine as an Adjuvant to Local Anesthesia in Brachial Plexus Block:A Systematic Review and Meta-Analysis of 18 Randomized Controlled Trials.[J]. Reg Anesth Pain Med,2017,42(2):184-196. doi: 10.1097/AAP.0000000000000564
[23]	Marhofer P,Brummett C M. Safety and efficiency of dexmedetomidine as adjuvant to local anesthetics.[J]. CurrOpinAnaesthesiol,2016,29(5):632-637.
[24]	Suresh S,Ecoffey C,Bosenberg A,et al. The european society of regional anaesthesia and pain therapy/american society of regional anesthesia and pain medicine recommendations on local anesthetics and adjuvants dosage in pediatric regional anesthesia[J]. Reg Anesth Pain Med,2018,43(2):211-216.
[25]	von Wulffen H,Heesemann J,BützowG H,et al. Detection of Campylobacter pyloridis in patients with antrum gastritis and peptic ulcers by culture,complement fixation test,and immunoblot.[J]. J Clin Microbiol,1986,24(5):716-720. doi: 10.1128/jcm.24.5.716-720.1986
[26]	Jaeger P,ZaricD,Fomsgaard J S,et al. Adductor canal block versus femoral nerve block for analgesia after total knee arthroplasty:a randomized,double-blind study.[J]. Reg Anesth Pain Med,2013,38(6):526-532. doi: 10.1097/AAP.0000000000000015
[27]	Abdallah F W,Whelan D B,Chan V W,et al. Adductor canal block provides noninferior analgesia and superior quadriceps strength compared with femoral nerve block in anterior cruciate ligament reconstruction[J]. Anesthesiology,2016,124(5):1053-1064. doi: 10.1097/ALN.0000000000001045
[28]	Kim H Y,Williamson J M,Lyles C M. Sample-size calculations for studies with correlated ordinal outcomes.[J]. Stat Med,2005,24(19):2977-2987. doi: 10.1002/sim.2162

Relative Articles(20)

Relative Articles

[1]	Jingjing ZHU, Xiaolei PEI, Hui WANG, Jinqiao QIAN. Cardiac Protective Mechanism of Dexmedetomidine and Its Application in Clinic. Journal of Kunming Medical University, 2025, 46(8): 1-9.
[2]	Yunli YANG, Na LI, Changming QIU, Junjie PU, Wei NIE, Zhigui LI. Effect of Ultrasound-guided Transmuscular Quadratus Lumborum Block for Postoperative Analgesia in Pediatric Patient Undergoing Hip Surgery. Journal of Kunming Medical University, 2023, 44(4): 88-92. doi: 10.12259/j.issn.2095-610X.S20230426
[3]	Yan CAO, Hong-yan JIANG, Yan-xue WANG, Dou-wei WU, Chuan-yun QIAN, Hai-ying WU, Ping LI. Dexmedetomidine Inhibits Neuronal Apoptosis after Traumatic Brain Injury in Rats. Journal of Kunming Medical University, 2021, 42(2): 1-5. doi: 10.12259/j.issn.2095-610X.S20210202
[4]	Yuan YANG, Li-jia PENG, Lan-qing PU, Jun-jie LI, Jian-lin SHAO, Xin YANG. Application of Propofol Combined with Dexmedetomidine or Midazolam in Painless Gastrointestinal Endoscopy in the Elderly. Journal of Kunming Medical University, 2021, 42(2): 43-48. doi: 10.12259/j.issn.2095-610X.S20210221
[5]	Yun-rui GUO, Jian-ming YANG, Hao YANG, Ye-cai ZHANG, Guo-yun ZHANG, Chen ZHOU, Ya-ting HOU. The Clinical Study on the Effects of Sedation，Analgesia and Slow Induction of Endotracheal Intubation on Hemodynamics，Reduction of Postoperative Adverse Memory and Psycho-psychological Effects in Patients with General Anesthesia. Journal of Kunming Medical University, 2021, 42(9): 127-133. doi: 10.12259/j.issn.2095-610X.S20210906
[6]	Zhao-sen FENG, Yu FANG, Ding-qin OU, Yi-han YANG, Zhi-yao WANG, Jie HUANG. Clinical Effect of Dexmedetomidine and Dexamethasone as Adjuvants for Brachial Plexus Block. Journal of Kunming Medical University, 2021, 42(10): 68-75. doi: 10.12259/j.issn.2095-610X.S20211005
[7]	Mai-qiao YANG, Fu-rong ZHANG, Li-li LIU, Xiao-ying LIU, ping LIU. Clinical Effect of Dexmedetomidine on Shivering Reaction in Cesarean Section Patients during Combined Spinal-epidural Anesthesia. Journal of Kunming Medical University, 2020, 41(11): 98-102. doi: 10.12259/j.issn.2095-610X.S20201125
[8]	Liu YANG, Qi-cai QU, Rui CHEN, Shu-lan JIAO, Yong-yu SI, Hua ZHOU. Effects of Dexmedetomidine on Inflammatory Response in Rats with Smoke Inhalation Lung Injury. Journal of Kunming Medical University, 2020, 41(11): 30-37. doi: 10.12259/j.issn.2095-610X.S20201124
[9]	Qing-qing XIONG, Xiao-dong LUO, Bu-fang FU, Jia-yi ZHONG, Guo-lian HE. Effects of Dexmedetomidine on Respiration in Postoperative Patients Undergone General Anesthesia at High Altitude Areas. Journal of Kunming Medical University, 2020, 41(12): 85-88. doi: 10.12259/j.issn.2095-610X.S20201224
[10]	Wang Xing Yao , Qian Jin Qiao . . Journal of Kunming Medical University, 2020, 41(08): 46-51.
[11]	Yang Yue, Tao Jian Ping . . Journal of Kunming Medical University, 2019, 40(12): 135-139.
[12]	Liu Wang Sheng , Wang Jin Hong , Huang Huan . . Journal of Kunming Medical University, 2019, 40(07): 41-46.
[13]	Li Wen Feng , Fan Xiao Hua , Dong Fa Tuan , Li Na . . Journal of Kunming Medical University, 2017, 38(02): 118-121.
[14]	Song Shi Qin . Influence of Dexmedetomidine on the Oxygenation and Cardio-pulmonary Function of Elderly Patients with Surgery. Journal of Kunming Medical University, 2017, 38(07): 122-125.
[15]	Qiao Fei , Wang Jun, Zhan Xi , Yang Wen Yan . Clinical Application of Ultrasound-guided Paravertebral Nerve Block in Analgesia after Thoracotomy. Journal of Kunming Medical University, 2017, 38(06): 87-91.
[16]	Zhang Can Hua , Qian Jin Qiao . . Journal of Kunming Medical University, 2017, 38(02): 54-57.
[17]	Chen Yong Lun . . Journal of Kunming Medical University,
[18]	Dan Ke Ji . . Journal of Kunming Medical University,
[19]	Wen Kai Lan . . Journal of Kunming Medical University,
[20]	Li Cui Lin . . Journal of Kunming Medical University,