ArticleArchives of orthopaedic and trauma surgery2025
Local infiltration anesthesia with high dose ropivacaine and dexmedetomidine in major knee surgery is safe.
Article in Archives of orthopaedic and trauma surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Effects of ultrasound-guided transversus abdominis plane block with combined dexmedetomidine and dexamethasone on the stress and immune function.BMC anesthesiology · 2025Trial
- Effect of Dezocine and Dexmedetomidine as Adjuvants in Ropivacaine for Incision Subcutaneous Infiltration Anesthesia on Incision Healing in Diabetic Rats.Brain and behavior · 2025Article
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Authors and funding
5 authors.
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Abstract
backgroundThe role of local infiltration anesthesia (LIA) in knee surgery is significant. LIA can be more potent than a nerve block, but without the downsides. A wide range of agents are used for LIA, including some off-label medications such as dexmedetomidine and ropivacaine. Dexmedetomidine has recently received attention for decreasing demand for anesthetic agents and prolonged effect of anesthesia. The purpose of this study was to demonstrate safety of dexmedetomidine and ropivacaine as LIA.
methodsThis is a retrospective analysis of 200 patients receiving 300 mg of ropivacaine, 100 µg of dexmedetomidine and 10 mL of saline solution as LIA. Both agents are off-label for this use. The LIA applied prior to skin closure as a pertiarticular block. Major knee surgery was defined as ligament reconstruction of at least one ligament, fracture of the femur and the tibia, knee replacement and osteotomy. We evaluated short-term major side-effects of these agents, and evaluated 30-day complications.
resultsIncluded were 77 arthroplasties, 10 fracture fixations, 19 osteotomies, 55 primary and revision ACL, 10 isolated medial patellar femoral ligament reconstructions, 2 ACLs combined with a partial knee arthroplasty, 4 cartilage transplantations and 23 multiligament knee reconstructions. We observed one transitory discoloration after an ACL reconstruction that disappeared by the 48 h mark. We had no 30-day superficial or deep infections. Cardiac or allergic reactions were not observed.
conclusionsLIA in a combination of single high-dose ropivacaine and dexmedetomidine is safe in knee surgery. Further studies evaluating pain relief with this LIA combination are needed.
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