BACKGROUND:

Arthroscopic knee surgery refers to different surgical interventions in the knee joint and many studies investigated postoperative pain control, Adductor canal block (ACB) as a new alternative technique to femoral nerve block (FNB) provides post-operative pain control with a multimodal analgesic regimen after knee surgery with better quadriceps muscle strength, Many adjuvants have been added to local anesthetics to prolong the analgesic duration of ACB like dexamethasone and dexmedetomidine.

PATIENTS AND METHODS:

A prospective, randomized, double-blind, parallel-four groups trial. A total of 120 patients scheduled for elective ACL repair; American society of anesthesiologists- physical status I and II patients, aged 18 to 60 years, 155-170 cm height, both sexes. Patients were randomized into four groups dexamethasone group (DX)group in which dexamethasone was added to bupivacaine in ACB, dexmedetomidine (Dm) group in which dexmedetomidine added to bupivacaine in ACB, magnesium sulfate (m) group in which magnesium sulfate was added to bupivacaine in ACB and control group with normal saline added to bupivacaine in ACB. The main outcome measure was the duration of postoperative analgesia.

RESULTS:

The results revealed that the addition of 8 mg dexamethasone or 25 µg dexmedetomidine to 0.5% bupivacaine solution during ACB improved the duration and the quality of postoperative analgesia but the addision of magnesium sulfate had no role.

CONCLUSIONS:

We concluded that the addition of dexamethasone or dexmedetomidine to bupivacaine in ACB after arthroscopic ACL repair under spinal anesthesia provided longer postoperative analgesia and less analgesic consumption.