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Addition of Dexmedetomidine, a Sedative-analgesic Agent, to Femoral Nerve Block for Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials

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October 10, 2022

Addition of Dexmedetomidine, a Sedative-analgesic Agent, to Femoral Nerve Block for Total Knee Arthroplasty: A Systematic Review of Randomized Controlled Trials

Vol: 5| Issue: 10| Number:2| ISSN#: 2563-559X

Authored By: Yaping Chang, Steve Philips, Ellen Scholl, Selina Bains, Mohit Bhandari On Behalf of OrthoEvidence

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  • In this OE Original, we conducted a systematic review and meta-analysis to examine evidence from randomized controlled trials (RCTs) comparing femoral nerve block (FNB) with and without the addition of dexmedetomidine for patients undergoing total knee arthroplasty (TKA).
  • In total, 6 published RCTs were included.
  • Moderate quality of evidence suggests that the addition of dexmedetomidine to the usual analgesic agents used for FNB is associated with small benefits in pain at rest versus control for patients undergoing TKA 12 and 48 hours after intervention. There is no significant difference between the two groups in pain at rest at 4-6 hours or 24 hours of follow-up with low quality of evidence.
  • Moderate to high quality of evidence suggests that addition of dexmedetomidine to the usual analgesic agents for FNB is associated with small benefits in pain during movement versus control for patients undergoing TKA 6, 12, 24 and 48 hours after intervention.
  • Moderate quality of evidence suggests that addition of dexmedetomidine to the usual analgesic agents for FNB significantly reduced total morphine consumption versus control for patients undergoing TKA at 24 or 48 hours of follow-up.
  • Addition of dexmedetomidine to the usual analgesic agents for FNB appears to be safe for postoperative pain control in patients undergoing TKA. No significant differences between the intervention and control groups were identified in incidence of adverse events at 24 or 48 hours of follow-up.
Total knee arthroplasty (TKA) is a common and effective treatment for patients with end-stage knee osteoarthritis. There has been an increase in the rate of TKA worldwide. Over 170,000 primary TKAs (209 per 100,000 population) were performed in Germany in 2018 (Klug et al., 2021). Studies predict that the annual total number of primary TKAs will reach 1,429,000 in the United States by 2040 and approximately 226,000 (47,313 per 100,000 population) in Germany by 2050 (Singh et al., 2019; Klug et al., 2021). However, TKA is often accompanied with

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