Effects of intranasal dexmedetomidine premedication on hemodynamics, oxygenation and bleeding in patients undergoing total knee arthroplasty under spinal anesthesia - a secondary analysis of a prospective, double-blinded, randomized controlled trial (TKADEX)
Authors' conclusion
Intranasal dexmedetomidine appears to be hemodynamically well tolerated premedication for patients undergoing TKA under spinal anesthesia. It appears to lower the incidence of intraoperative hypertension without effects on intraoperative bleeding.
Study context
- Population
- Patients undergoing total knee arthroplasty (TKA) under spinal anaesthesia
- Participants
- 101 planned subjects
- Comparison
- Intranasal dexmedetomidine premedication vs intranasal saline
Methodological detailssingle-centre, double-blind, two-arm
- Single-centre
- Double-blind
- Two-arm
Primary result
As reported in the abstract
Perioperative hemodynamics: decrease from baseline after induction of spinal anaesthesia; intraoperative mean arterial pressure (MAP) and HR
Dexmedetomidine vs PlaceboMaximal difference in intraoperative MAP, mmHg (95 % CI)P value
Spread (2.5)
- 8.5(−13.5 - −3.5)
P < 0.001Dexmedetomidine vs PlaceboMaximal difference in intraoperative HR, bpm (95 % CI)P value
Spread (2.2)
- 6.1(−10.5 - −1.7)
P = 0.007Further findings
| Outcome | P value |
|---|---|
| Intraoperative hypertensionHigher incidence in placebo | P = 0.03 |
Oxygenation, intraoperative bradycardia, tachycardia or hypotension, intraoperative bleeding, perioperative blood count change
- No difference between the groups
Original publication
Effects of intranasal dexmedetomidine premedication on hemodynamics, oxygenation and bleeding in patients undergoing total knee arthroplasty under spinal anesthesia - a secondary analysis of a prospective, double-blinded, randomized controlled trial (TKADEX). J Clin Anesth. Published 11 June 2025. doi:10.
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