Intravenous Versus Perineural Dexmedetomidine as Adjuvant in Adductor Canal Block for Total Knee Arthroplasty (dexmed_ACB)

  • End date
    Dec 31, 2022
  • participants needed
  • sponsor
    Mansoura University
Updated on 14 April 2022


Shivering increases the cardiac and systemic energy expenditure, oxygen consumption and carbon dioxide production. Definitive prevention and treatment of shivering is necessary to decrease the related complications and increase post-anesthetic comfort.


Dexmedetomidine a highly selective α2 adrenergic agonist used effectively as a safe analgesic via different routes and mechanisms, including intravenous (i.v.), neuraxial and perineural routes. Dexmedetomidine has been used for prevent shivering but, the results of its efficacy is still controversy.

No studies to date have investigated the best administration route of dexmedetomidine to dominantly prevent the occurrence of shivering after spinal anesthesia or associated with the least grade.

This prospective, randomized, double blinded study was designed to investigate the best administrative route of dexmedetomidine firstly, as a preventive of neuraxial shivering and secondly as adjunctive analgesic.

The incidence of post-spinal anesthesia shivering was the primary outcome. Perioperative hemodynamics, postoperative pain scores during rest and at 45-degree flexion of the knee, the analgesic duration, the first postoperative day analgesic consumption, the sedation score and early ambulation ability were the secondary outcomes.

Condition Post Spinal Anesthesia Shivering
Treatment Intravenous Dexmedetomidine, adductor canal block dexmedetomidine
Clinical Study IdentifierNCT04266145
SponsorMansoura University
Last Modified on14 April 2022


Yes No Not Sure

Inclusion Criteria

adult patients
both genders
American Society of Anesthesiologists physical status I and II
scheduled for unilateral primary TKA under spinal anesthesia

Exclusion Criteria

chronic opioid use
known allergy to the used drugs
any contraindications to regional anesthesia like; patient refusal, coagulopathy, neuropathy or infection at the injection site
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