Impact of postoperative continuous infusion of dexmedetomidine on the quality of early recovery in patients undergoing ambulatory knee arthroscopy_West China Medical Journal

Authors：

TU Yanling ¹ , LI Caixia ¹ , LU Yao ^1,2 , LIU Xuesheng ¹ , CHEN Shangui ¹ ,  CHENG Xinqi ^1,2

1. Department of Anesthesiology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P. R. China;
2. Day Surgery Center, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P. R. China;

Corresponding author：

CHENG Xinqi, Email: ch_xqmz@163.com

Keywords：

Dexmedetomidine; day surgery; knee arthroscopy; early quality of life; quality of sleep

DOI：

10.7507/1002-0179.202411058

Video：

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Objective To evaluate the effectivity of dexmedetomidine on the early postoperative quality of recovery in patients undergoing ambulatory knee arthroscopy under general anesthesia. Methods Patients scheduled for knee arthroscopy at the Day Surgery Center of the First Affiliated Hospital of Anhui Medical University between June and September 2024 were selected. According to the computer-generated random allocation, patients were randomly divided into the dexmedetomidine group (Dex group) and the saline control group (NS group). The Dex group received a continuous infusion of dexmedetomidine at a rate of 0.04 µg/(kg·h) until discharge, whereas the NS group was administered a comparable volume of saline. The primary outcome measure was the EuroQol Five-Dimensional Five-Level (EQ-5D-5L) score for health-related quality of life measured at the postoperative 24 hours. Secondary outcome measures included the Athens Insomnia Scale score on the night of surgery and the incidence of adverse reactions such as nausea and vomiting within 24 hours postoperatively. Results A total of 60 patients were included, with 30 patients in each group. There were statistically significant differences in the EQ-5D-5L health scores at the postoperative 24 hours (0.857±0.081 vs. 0.721±0.098) and the Athens Insomnia Scale scores [2.00 (2.00, 3.00) vs. 4.00 (3.00, 5.25)] on the night of surgery between the Dex group and the NS group (P<0.05). The difference in the incidence of postoperative nausea and vomiting between the two groups was not statistically significant [1 case (3.3%) vs. 5 cases (16.7%); χ²=1.667, P=0.197]. No adverse reactions such as bradycardia, hypotension, urinary retention, respiratory depression, dizziness and lethargy occurred in both groups. Conclusion Dexmedetomidine can significantly improve the early postoperative quality of life and sleep in patients undergoing ambulatory knee arthroscopy, thereby facilitating early postoperative quality of recovery.

Citation： TU Yanling, LI Caixia, LU Yao, LIU Xuesheng, CHEN Shangui, CHENG Xinqi. Impact of postoperative continuous infusion of dexmedetomidine on the quality of early recovery in patients undergoing ambulatory knee arthroscopy. West China Medical Journal, 2025, 40(2): 217-222. doi: 10.7507/1002-0179.202411058 Copy

1.	Gebhardt V, Zawierucha V, Schöffski O, et al. Spinal anaesthesia with chloroprocaine 1% versus total intravenous anaesthesia for outpatient knee arthroscopy: a randomised controlled trial. Eur J Anaesthesiol, 2018, 35(10): 774-781.
2.	肖文峰, 高曙光. 关节镜日间手术临床实践专家共识. 中国内镜杂志, 2020, 26(6): 1-7.
3.	覃兆军, 马广胜, 向春艳, 等. 基于加速康复外科膝关节镜日间手术模式与传统住院模式的对比研究. 安徽医药, 2023, 27(4): 711-715.
4.	Weerink MAS, Struys MMRF, Hannivoort LN, et al. Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine. Clin Pharmacokinet, 2017, 56(8): 893-913.
5.	Li Y, Wang B, Zhang L, et al. Dexmedetomidine combined with general anesthesia provides similar intraoperative stress response reduction when compared with a combined general and epidural anesthetic technique. Anesth Analg, 2016, 122(4): 1202-1210.
6.	Sun JJ, Xiang XB, Xu GH, et al. A novel opioid-sparing analgesia following thoracoscopic surgery: a non-inferiority trial. Drug Des Devel Ther, 2023, 17: 1641-1650.
7.	Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA, 2009, 301(5): 489-499.
8.	Colin PJ, Hannivoort LN, Eleveld DJ, et al. Dexmedetomidine pharmacokinetic–pharmacodynamic modelling in healthy volunteers: 1. Influence of arousal on bispectral index and sedation. Br J Anaesth, 2017, 119(2): 200-210.
9.	EuroQol Group. EuroQol -- a new facility for the measurement of health-related quality of life. Health Policy, 1990, 16(3): 199-208.
10.	Herdman M, Gudex C, Lloyd A, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res, 2011, 20(10): 1727-1736.
11.	Xu RH, Luo N, Dong D. Measurement properties of the EQ-5D-3L, EQ-5D-5L, and SF-6Dv2 in patients with late-onset pompe disease. Eur J Health Econ, 2024, 25(9): 1505-1515.
12.	Luo N, Liu G, Li M, et al. Estimating an EQ-5D-5L value set for China. Value Health, 2017, 20(4): 662-669.
13.	Chang J, Fu M, Cao P, et al. Patient-reported quality of life before and after total knee arthroplasty: a multicenter observational study. Patient Prefer Adherence, 2022, 16: 737-748.
14.	Song B, Li Y, Teng X, et al. Comparison of morning and evening operation under general anesthesia on intraoperative anesthetic requirement, postoperative sleep quality, and pain: a randomized controlled trial. Nat Sci Sleep, 2020, 12: 467-475.
15.	Peng L, Song Y, Lv B, et al. The effect of implementation of pain neuroscience education and rehabilitation exercise on post-operative pain and recovery after laparoscopic colorectal surgery: a prospective randomized controlled trial. J Anesth, 2023, 37(5): 775-786.
16.	Soldatos CR, Dikeos DG, Paparrigopoulos TJ. The diagnostic validity of the Athens insomnia scale. J Psychosom Res, 2003, 55(3): 263-267.
17.	Wong J, Tong D, De Silva Y, et al. Development of the functional recovery index for ambulatory surgery and anesthesia. Anesthesiology, 2009, 110(3): 596-602.
18.	Choojaturo S, Sindhu S, Utriyaprasit K, et al. Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study. BMC Health Serv Res, 2019, 19(1): 688.
19.	Li HJ, Li CJ, Wei XN, et al. Dexmedetomidine in combination with morphine improves postoperative analgesia and sleep quality in elderly patients after open abdominal surgery: a pilot randomized control trial. PloS One, 2018, 13(8): e0202008.
20.	Ju JY, Kim KM, Lee S. Effect of preoperative administration of systemic alpha-2 agonists on postoperative pain: a systematic review and meta-analysis. Anesth Pain Med (Seoul), 2020, 15(2): 157-166.
21.	Tang C, Hu Y, Zhang Z, et al. Dexmedetomidine with sufentanil in intravenous patient-controlled analgesia for relief from postoperative pain, inflammation and delirium after esophageal cancer surgery. Biosci Rep, 2020, 40(5): BSR20193410.
22.	Xin J, Zhang Y, Zhou L, et al. Effect of dexmedetomidine infusion for intravenous patient-controlled analgesia on the quality of recovery after laparotomy surgery. Oncotarget, 2017, 8(59): 100371-100383.
23.	Wang YQ, Zhang XJ, Wang Y. Effect of intrathecal dexmedetomidine on cesarean section during spinal anesthesia: a meta-analysis of randomized trials. Drug Des Devel Ther, 2019, 13: 2933-2939.
24.	Huang X, Lin D, Sun Y, et al. Effect of dexmedetomidine on postoperative sleep quality: a systematic review. Drug Des Devel Ther, 2021, 15: 2161-2170.
25.	Jin X, Xiao R, Zhou W, et al. Effect of different modes of administration of dexmedetomidine combined with nerve block on postoperative analgesia in total knee arthroplasty. Pain Ther, 2021, 10(2): 1649-1662.
26.	Blaudszun G, Lysakowski C, Elia N, et al. Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials. Anesthesiology, 2012, 116(6): 1312-1322.

1. Gebhardt V, Zawierucha V, Schöffski O, et al. Spinal anaesthesia with chloroprocaine 1% versus total intravenous anaesthesia for outpatient knee arthroscopy: a randomised controlled trial. Eur J Anaesthesiol, 2018, 35(10): 774-781.
2. 肖文峰, 高曙光. 关节镜日间手术临床实践专家共识. 中国内镜杂志, 2020, 26(6): 1-7.
3. 覃兆军, 马广胜, 向春艳, 等. 基于加速康复外科膝关节镜日间手术模式与传统住院模式的对比研究. 安徽医药, 2023, 27(4): 711-715.
4. Weerink MAS, Struys MMRF, Hannivoort LN, et al. Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine. Clin Pharmacokinet, 2017, 56(8): 893-913.
5. Li Y, Wang B, Zhang L, et al. Dexmedetomidine combined with general anesthesia provides similar intraoperative stress response reduction when compared with a combined general and epidural anesthetic technique. Anesth Analg, 2016, 122(4): 1202-1210.
6. Sun JJ, Xiang XB, Xu GH, et al. A novel opioid-sparing analgesia following thoracoscopic surgery: a non-inferiority trial. Drug Des Devel Ther, 2023, 17: 1641-1650.
7. Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA, 2009, 301(5): 489-499.
8. Colin PJ, Hannivoort LN, Eleveld DJ, et al. Dexmedetomidine pharmacokinetic–pharmacodynamic modelling in healthy volunteers: 1. Influence of arousal on bispectral index and sedation. Br J Anaesth, 2017, 119(2): 200-210.
9. EuroQol Group. EuroQol -- a new facility for the measurement of health-related quality of life. Health Policy, 1990, 16(3): 199-208.
10. Herdman M, Gudex C, Lloyd A, et al. Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L). Qual Life Res, 2011, 20(10): 1727-1736.
11. Xu RH, Luo N, Dong D. Measurement properties of the EQ-5D-3L, EQ-5D-5L, and SF-6Dv2 in patients with late-onset pompe disease. Eur J Health Econ, 2024, 25(9): 1505-1515.
12. Luo N, Liu G, Li M, et al. Estimating an EQ-5D-5L value set for China. Value Health, 2017, 20(4): 662-669.
13. Chang J, Fu M, Cao P, et al. Patient-reported quality of life before and after total knee arthroplasty: a multicenter observational study. Patient Prefer Adherence, 2022, 16: 737-748.
14. Song B, Li Y, Teng X, et al. Comparison of morning and evening operation under general anesthesia on intraoperative anesthetic requirement, postoperative sleep quality, and pain: a randomized controlled trial. Nat Sci Sleep, 2020, 12: 467-475.
15. Peng L, Song Y, Lv B, et al. The effect of implementation of pain neuroscience education and rehabilitation exercise on post-operative pain and recovery after laparoscopic colorectal surgery: a prospective randomized controlled trial. J Anesth, 2023, 37(5): 775-786.
16. Soldatos CR, Dikeos DG, Paparrigopoulos TJ. The diagnostic validity of the Athens insomnia scale. J Psychosom Res, 2003, 55(3): 263-267.
17. Wong J, Tong D, De Silva Y, et al. Development of the functional recovery index for ambulatory surgery and anesthesia. Anesthesiology, 2009, 110(3): 596-602.
18. Choojaturo S, Sindhu S, Utriyaprasit K, et al. Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study. BMC Health Serv Res, 2019, 19(1): 688.
19. Li HJ, Li CJ, Wei XN, et al. Dexmedetomidine in combination with morphine improves postoperative analgesia and sleep quality in elderly patients after open abdominal surgery: a pilot randomized control trial. PloS One, 2018, 13(8): e0202008.
20. Ju JY, Kim KM, Lee S. Effect of preoperative administration of systemic alpha-2 agonists on postoperative pain: a systematic review and meta-analysis. Anesth Pain Med (Seoul), 2020, 15(2): 157-166.
21. Tang C, Hu Y, Zhang Z, et al. Dexmedetomidine with sufentanil in intravenous patient-controlled analgesia for relief from postoperative pain, inflammation and delirium after esophageal cancer surgery. Biosci Rep, 2020, 40(5): BSR20193410.
22. Xin J, Zhang Y, Zhou L, et al. Effect of dexmedetomidine infusion for intravenous patient-controlled analgesia on the quality of recovery after laparotomy surgery. Oncotarget, 2017, 8(59): 100371-100383.
23. Wang YQ, Zhang XJ, Wang Y. Effect of intrathecal dexmedetomidine on cesarean section during spinal anesthesia: a meta-analysis of randomized trials. Drug Des Devel Ther, 2019, 13: 2933-2939.
24. Huang X, Lin D, Sun Y, et al. Effect of dexmedetomidine on postoperative sleep quality: a systematic review. Drug Des Devel Ther, 2021, 15: 2161-2170.
25. Jin X, Xiao R, Zhou W, et al. Effect of different modes of administration of dexmedetomidine combined with nerve block on postoperative analgesia in total knee arthroplasty. Pain Ther, 2021, 10(2): 1649-1662.
26. Blaudszun G, Lysakowski C, Elia N, et al. Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials. Anesthesiology, 2012, 116(6): 1312-1322.

West China Medical Journal

Impact of postoperative continuous infusion of dexmedetomidine on the quality of early recovery in patients undergoing ambulatory knee arthroscopy

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