The effectiveness of dexmedetomidine in controlling the stress response during anterior cruciate ligament reconstruction | Ukrainian Medical Journal

The purpose of the study is to compare the effects of isolated spinal anesthesia (SA) and combined anesthesia techniques on the dynamics of metabolic stress markers (glucose, cortisol, lactate) in patients undergoing arthroscopic reconstruction of the anterior cruciate ligament (ACL) of the knee. Materials and methods. 120 patients, divided into three groups, of both sexes, with ACL injuries who underwent arthroscopic ACL reconstruction. Group SA (n=40) received an isobaric solution of 0.5% bupivacaine 13 mg without an adjuvant. Group SA+D (n=40) received 13 mg of 0.5% isobaric bupivacaine solution and 100 μg of dexmedetomidine intrathecally. Group SA+B+D (n=40) received an intrathecal injection of 8 mg of 0.5% isobaric bupivacaine solution and 20 μg of fentanyl; for femoral and sciatic nerve blocks, 20 mL of 0.25% bupivacaine and 100 μg of dexmedetomidine were administered into each. Results. The most effective regimen was SA+B+D, which delays the stress response until noon while maintaining minimal blood glucose levels. Conclusion. SA+B+D maintains stable levels of glucose (p<0.02), lactate (p<0.001), and cortisol (p<0.05) compared to SA+D and SA.

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