Premedication with intranasal dexmedetomidine in patients undergoing total knee arthroplasty under spinal anaesthesia (TKADEX)—a prospective, double-blinded, randomised controlled trial
Authors' conclusion
Our results indicate that intranasal dexmedetomidine may reduce postoperative pain and the requirement for additional sedation and increase short-term patient satisfaction in patients undergoing total knee arthroplasty.
Study context
- Population
- Consecutive elective patients undergoing total knee arthroplasty under spinal anaesthesia
- Participants
- 101 patients
- Comparison
- Intranasal dexmedetomidine vs intranasal saline premedication
- Primary endpoint
- Postoperative pain (NRS)
- Follow-up
- First 24 h
Methodological detailssingle-centre, double-blind, two-arm
- Single-centre
- Double-blind
- Two-arm
Primary result
As reported in the abstract
3 h
Dexmedetomidine
2.0
median · IQR 0.0–3.0
Control
3.0
median · IQR 2.0–4.0
P = 0.037
Secondary outcomes
Cumulative 24 h opioid requirement (morphine equivalents) · did not differ
P = 0.334
| Outcome | P value |
|---|---|
| Satisfaction with pain management in the wardMore patients satisfied with dexmedetomidine | P = 0.0013 |
Safety
| Outcome | P value |
|---|---|
| PONVDid not differ | P = 0.310 |
| Haemodynamic adverse eventsDid not differ | P > 0.27 for all |
Original publication
Premedication with intranasal dexmedetomidine in patients undergoing total knee arthroplasty under spinal anaesthesia (TKADEX)—a prospective, double-blinded, randomised controlled trial. BJA Open. Published 3 March 2025. doi:10.
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