A dose reduction study of local anesthetic with addition of dexmedetomidine on postoperative epidural analgesia after total knee arthroplasty

Peer review under responsibility of Egyptian Society of Anesthesiologists.

Figures & data

able 1 Demographic data.

Character	Group I	Group II	Group III	P-value
Age (years)	58.88 ± 4.77	60.2 ± 3.89	59.12 ± 4.87	0.55
Sex (F/M)	14/11	13/12	10/15	0.5
Weight (kg)	86.64 ± 6.82	86.16 ± 6.99	85.76 ± 6.53	0.9
Height (cm)	159.08 ± 6.99	161 ± 6.89	163.12 ± 8.83	0.18

Group I: Bupivacaine (5 ml/h), Group II: Dexmeditomidine + 4 ml/h bupivacaine, Group III: Dexmeditomidine + 3 ml/h bupivacaine, F: Female, and M: Male.

Data were expressed as mean ± SD and number of patients.

able 2 VAS at rest.

Time (h)	Group I	Group II	Group III	P-value
4	4.2 ± 2.15^⁎^†	2.5 ± 1.4	2.6 ± 1.3	<0.001
8	3.48 ± 1.45	2.3 ± 1.6	2.4 ± 1.5	0.009
12	3.04 ± 1.1^⁎^†	2.05 ± 1.14	2.07 ± 1.13	0.003
16	2.85 ± 0.91^⁎^†	1.87 ± 1.0	1.89 ± 1.1	<0.001
20	2.77 ± 0.85^⁎^†	1.77 ± 0.98	1.8 ± 1.0	<0.001
24	2.68 ± 0.76	2.15 ± 0.84	2.16 ± 0.85	0.038
28	2.46 ± 0.83	2.16 ± 0.76	2.18 ± 0.87	0.358
32	2.43 ± 0.81	2.13 ± 0.74	2.16 ± 0.75	0.320
36	2.4 ± 0.87	2.11 ± 0.72	2.13 ± 0.73	0.342
40	2.39 ± 0.89	1.99 ± 0.9	2.1 ± 0.72	0.228
44	2.36 ± 0.91	1.94 ± 0.8	1.92 ± 0.7	0.101
48	2.34 ± 0.81	1.87 ± 0.75	1.88 ± 0.73	0.052

Group I: Bupivacaine (5 ml/h), Group II: Dexmeditomidine + 4 ml/h bupivacaine, Group III: Dexmeditomidine + 3 ml/h bupivacaine.

Data were expressed as mean ± SD.

#x204E; Significance between group I and group II.

#x2020; Significance between group I and group III.

able 3 VAS at movement.

Time (h)	Group I	Group II	Group III	P-value
4	5.08 ± 1.41^⁎^†	4.11 ± 1.36	4.14 ± 1.38	0.023
8	4.92 ± 1.29^⁎^†	3.88 ± 0.98	4.04 ± 1.27	0.006
12	4.76 ± 1.3^⁎^†	3.82 ± 0.97	3.84 ± 0.99	0.004
16	4.7 ± 1.36^⁎^†	3.68 ± 0.86	3.72 ± 0.94	0.001
20	4.6 ± 1.35^⁎^†	3.6 ± 0.88	3.65 ± 0.86	0.001
24	4.32 ± 1.28^⁎^†	3.52 ± 0.76	3.48 ± 0.77	0.004
28	4.12 ± 1.09^⁎^†	3.2 ± 0.74	3.4 ± 0.79	0.001
32	3.98 ± 1.03^⁎^†	3.15 ± 0.75	3.36 ± 0.81	0.003
36	3.88 ± 0.97^⁎^†	3.1 ± 0.74	3.16 ± 0.75	0.002
40	3.68 ± 0.85^⁎^†	3.09 ± 0.77	3.1 ± 0.73	0.013
44	3.54 ± 0.73^⁎^†	3.02 ± 0.72	3.08 ± 0.76	0.029
48	3.36 ± 0.64^⁎^†	2.66 ± 0.7	2.76 ± 0.6	<0.001

Group I: Bupivacaine (5 ml/h), Group II: Dexmeditomidine + 4 ml/h bupivacaine, Group III: Dexmeditomidine + 3 ml/h bupivacaine.

Data were expressed as mean ± SD.

#x204E; Significance between group I and group II.

#x2020; Significance between group I and group III.

able 4 Nalbuphine consumption.

Time (h)	Group I	Group II	Group III	P-value
4	3.76 ± 0.66^⁎^†	2.96 ± 1.02	3.2 ± 1.0	0.008
8	3.6 ± 0.82^⁎^†	2.88 ± 1.01	3.04 ± 1.02	0.024
12	3.28 ± 0.98^⁎^†	2.56 ± 0.92	2.72 ± 0.98	0.025
16	2.8 ± 1.0^⁎^†	2.16 ± 0.55	2.32 ± 0.75	0.015
20	2.48 ± 0.87^⁎^†	1.84 ± 0.55	2.0 ± 0.58	0.004
24	3.38 ± 0.95^⁎^†	2.64 ± 0.95	2.8 ± 1.0	0.021
28	3.12 ± 1.01^⁎^†	2.4 ± 0.82	2.56 ± 0.92	0.018
32	3.04 ± 1.02^⁎^†	2.32 ± 0.75	2.48 ± 0.87	0.014
36	2.8 ± 1.0^⁎^†	2.16 ± 0.55	2.32 ± 0.75	0.015
40	2.48 ± 0.87^⁎^†	1.84 ± 0.55	2.0 ± 0.58	0.004
44	2.4 ± 0.82^⁎^†	1.76 ± 0.66	1.92 ± 0.4	0.002
48	2.56 ± 0.92^⁎^†	1.92 ± 0.4	2.08 ± 0.4	0.001

Group I: Bupivacaine (5 ml/h), Group II: Dexmeditomidine + 4 ml/h bupivacaine, Group III: Dexmeditomidine + 3 ml/h bupivacaine.

Data were expressed as mean ± SD.

#x204E; Significance between group I and group II.

#x2020; Significance between group I and group III.

able 5 Sedation score.

Time (h)	Group I	Group II	Group III	P-value
4	1.27 ± 0.45	1.54 ± 0.73	1.52 ± 0.7	0.257
8	1.28 ± 0.46^⁎^†	1.72 ± 0.68	1.7 ± 0.66	0.019
12	1.3 ± 0.47^⁎^†	1.79 ± 0.83	1.78 ± 0.77	0.024
16	1.32 ± 0.48^⁎^†	1.88 ± 0.83	1.87 ± 0.82	0.011
20	1.24 ± 0.44^⁎^†	1.78 ± 0.85	1.78 ± 0.84	0.014
24	1.21 ± 0.42^⁎^†	1.69 ± 0.81	1.68 ± 0.79	0.025
28	1.13 ± 0.34^⁎^†	1.67 ± 0.77	1.65 ± 0.75	0.006
32	1.14 ± 0.35^⁎^†	1.68 ± 0.8	1.69 ± 0.9	0.012
36	1.17 ± 0.37^⁎^†	1.76 ± 0.88	1.77 ± 0.89	0.008
40	1.18 ± 0.38^⁎^†	1.88 ± 0.93	1.86 ± 0.92	0.003
44	1.12 ± 0.33^⁎^†	1.68 ± 0.8	1.66 ± 0.7	0.004
48	1.07 ± 0.27^⁎^†	1.42 ± 0.41	1.41 ± 0.39	0.001

Group I: Bupivacaine (5 ml/h), Group II: Dexmeditomidine + 4 ml/h bupivacaine, Group III: Dexmeditomidine + 3 ml/h bupivacaine.

Data were expressed as mean ± SD.

#x204E; Significance between group I and group II.

#x2020; Significance between group I and group III.

able 6 Heart rate.

Time (h)	Group I	Group II	Group III	P-value
Base	77.08 ± 8.65	77.52 ± 9.28	72.24 ± 9.37	0.082
4	76.2 ± 8.63	76.56 ± 9.15	76.52 ± 8.94	0.988
8	75.92 ± 8.8	75.64 ± 8.3	75.88 ± 8.6	0.992
12	75.2 ± 8.54	75.08 ± 7.68	74.88 ± 8.09	0.990
16	74.52 ± 8.21	73.96 ± 6.62	74.2 ± 7.8	0.966
20	74.08 ± 7.6	73.32 ± 5.71	72.84 ± 6.87	0.809
24	73.88 ± 5.62	73.64 ± 7.48	73.16 ± 6.9	0.928
28	74.24 ± 5.67	72.16 ± 6.2	73.36 ± 6.82	0.501
32	72.44 ± 6.1	774.4 ± 5.61	73.04 ± 6.75	0.521
36	73.84 ± 5.34	71.2 ± 5.22	72.6 ± 6.45	0.267
40	73.12 ± 5.29	70.36 ± 4.38	70.4 ± 4.41	0.066
44	72.36 ± 5.01	70.92 ± 3.91	70.92 ± 4.11	0.409
48	72.68 ± 5.97	71.72 ± 3.9	71.56 ± 4.14	0.669

Group I: Bupivacaine (5 ml/h), Group II: Dexmeditomidine + 4 ml/h bupivacaine, Group III: Dexmeditomidine + 3 ml/h bupivacaine.

Data were expressed as mean ± SD.

able 7 Mean arterial blood pressure.

Time (h)	Group I	Group II	Group III	P-value
Base	97.92 ± 8.11	93 ± 6.89	94.88 ± 10.42	0.132
4	92.4 ± 7.97	90.27 ± 4.26	91.08 ± 6.93	0.516
8	82.44 ± 5.9^⁎^†	85.45 ± 5.01	88.96 ± 8^‡	0.003
12	80.92 ± 3.35^⁎^†	85.1 ± 4.49	88.6 ± 8.01^‡	<0.001
16	80 ± 3.43^⁎^†	85 ± 4.38	88.2 ± 5.79^‡	<0.001
20	77.88 ± 4.3^⁎^†	82.6 ± 4.73	86.16 ± 5.25^‡	<0.001
24	76 ± 4.69^⁎^†	82.2 ± 4.69	86.6 ± 5.19^‡	<0.001
28	76.56 ± 4.79^⁎^†	82.5 ± 5.02	87.12 ± 5.09^‡	<0.001
32	77.04 ± 5.02^⁎^†	83.2 ± 5.23	87.68 ± 5.03^‡	<0.001
36	79.04 ± 4.12^⁎^†	84.09 ± 4.23	88.52 ± 4.91^‡	<0.001
40	81.2 ± 4.69^⁎^†	85.32 ± 5.3	89.24 ± 4.64^‡	<0.001
44	83.08 ± 4.13^⁎^†	86.01 ± 5.35	90.28 ± 4.27^‡	<0.001
48	84.76 ± 5.64^⁎^†	87.88 ± 4.97	91.68 ± 4.47^‡	<0.001

Group I: Bupivacaine (5 ml/h), Group II: Dexmeditomidine + 4 ml/h bupivacaine, Group III: Dexmeditomidine + 3 ml/h bupivacaine.

Data were expressed as mean ± SD.

#x204E; Significance between group I and group II.

#x2020; Significance between group I and group III.

#x2021; Significance between group II and group III.