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The Effect of Adding Dexmedetomidine to Levobupivacaine for Interscalene Block for Postoperative Pain Management After Arthroscopic Shoulder Surgery

Bengisun, Züleyha K. MD*; Ekmekçi, Perihan MD*; Akan, Burak MD; Köroğlu, Ayşegül MD*; Tüzüner, Filiz MD*

Clinical Journal of Pain:
doi: 10.1097/AJP.0000000000000065
Original Articles
Abstract

Objective: Arthroscopic subacromial decompression may cause substantial postoperative pain. We undertook a randomized controlled trial to examine whether adding dexmedetomidine to the local anesthetic in an interscalene brachial plexus block and subsequent patient-controlled interscalene analgesia (PCIA) regime improved postoperative pain scores, patient satisfaction, rescue analgesic requirement, and local anesthetic consumption.

Methods: A total of 48 patients aged between 18 and 65 years undergoing arthroscopic subacromial decompression were enrolled and randomized into 1 of the 2 groups. Group L (n=25) received levobupivacaine and epinephrine, whereas Group LD (n=23) received levobupivacaine, epinephrine, and dexmedetomidine through an interscalene catheter. Four hours after surgery, a PCIA regime was commenced. In Group L patients were administered levobupivacaine and in Group LD levobupivacaine and dexmedetomidine. Demographic and hemodynamic data, duration of motor and sensory blocks, pain VAS, side effects, PCIA demand and delivery values, consumption of lornoxicam as a rescue analgesic, and patient satisfaction were recorded for 24 hours after surgery.

Results: PCIA demand and delivery, and pain VAS values were significantly lower, and patient satisfaction was significantly higher in the dexmedetomidine group (P=0.004, 0.001, 0.004, and 0.002, respectively). The side effect profile was similar between the groups. Levobupivacaine consumption was significantly lower in Group LD (P=0.009). In the first 24 postoperative hours, Group LD consumed significantly less lornoxicam (P=0.01).

Discussion: Addition of dexmedetomidine to levobupivacaine for interscalene brachial plexus block decreases pain scores and increases patient satisfaction after arthroscopic subacromial decompression.

Author Information

Departments of *Anesthesiology and Reanimation

Orthopedics and Traumatology, Ufuk University Dr Ridvan Ege Hospital, Ankara, Turkey

This article has been presented as an oral presentation in the 46th Annual Meeting of Turkish Anesthesiology and Reanimation Society in 7-11th November 2012, Northern Cyprus.

The authors declare no conflict of interest.

Reprints: Perihan Ekmekçi, MD, Department of Anesthesiology and Reanimation, Ufuk University Dr Ridvan Ege Hospital, Konya Yolu Mevlana Blv, Balgat 86-88 06520, Ankara, Turkey (e-mail: erdogduperi@gmail.com).

Received July 22, 2013

Received in revised form January 6, 2014

Accepted December 10, 2013

© 2014 by Lippincott Williams & Wilkins