Analgesic Effects of Fentanyl Versus Dexmedetomidine with Bupivacaine in Combined IPACK and Adductor Canal Block for Pain Relief After Knee Surgery

What this Trial Is About

Researchers are evaluating the pain relief effects of fentanyl versus dexmedetomidine when added to bupivacaine in combined IPACK and Adductor Canal Block (ACB) techniques after knee surgeries. The goal is to compare these two drugs as additional agents to manage postoperative pain following total knee arthroplasty and other knee procedures. The study includes adults aged 21 to 85 undergoing elective unilateral knee surgeries such as total knee arthroplasty, ACL reconstruction, or knee arthroscopy. Participants are divided into three groups. One group receives bupivacaine alone in the blocks, the second group receives bupivacaine plus fentanyl, and the third group receives bupivacaine plus dexmedetomidine. Each block is given via ultrasound guidance with 20 mL of 0.25% bupivacaine plus either saline, 50 mcg fentanyl, or up to 100 mcg dexmedetomidine. Treatments are applied to the knee area using the combined IPACK and ACB techniques. During the 48 hours after surgery, patients' pain levels at rest and during knee movement are assessed at several time points using a numerical rating scale. The total amount of rescue pain medication (tramadol) used is recorded, along with the time to first rescue analgesia. Researchers also monitor side effects such as hematoma, local anesthetic toxicity, infection, nausea, vomiting, and length of hospital stay. Patients will rate their overall satisfaction with pain relief using a five-point scale.

Comparison Between Fentanyl and Dexmedetomidine As Adjuvant to Bupivacaine in Combined IPACK and Adductor Canal Block for Postoperative Analgesia After Knee Surgeries