{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T01:49:06Z","timestamp":1784684946409,"version":"3.55.0"},"reference-count":28,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Reg Anesth Pain Med"],"accepted":{"date-parts":[[2020,9,25]]},"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background and objectives<\/jats:title>\n                  <jats:p>Peripheral nerve blocks reduce postoperative pain and enhance recovery after total knee arthroplasty (TKA). This study aims to assess the benefits of addition of intravenous dexmedetomidine (DexM) to intravenous dexamethasone on the analgesic duration of quadruple nerve blocks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This double-blind, randomized, controlled trial prospectively enrolled 90 patients scheduled for TKA under quadruple nerve blocks (sciatic, femoral, obturator, and lateral femoral cutaneous nerves blocks) with 70\u2009mL, 0.32% ropivacaine. All patients received systemic dexamethasone 10\u2009mg. Patients were randomized to receive DexM (2\u2009\u00b5g\/kg, intravenous) or placebo (1:1 ratio). The primary endpoint was the duration of analgesia defined as the time to first request for rescue analgesia (oxycodone).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Kaplan-Meier curves for the first analgesic request were similar between groups (log-rank test; p=0.27). Median (IQR) duration of analgesia was similar between placebo (1575\u2009min (1211\u20131952)) and DexM (1470\u2009min (1263\u20131700)) groups (p=0.56). Cumulative consumption of oxycodone at the 48th hour was 20\u2009mg (10\u201330) and 30\u2009mg (20\u201340) in placebo and DexM groups, respectively (p=0.14). The day after surgery, 93% and 89% of patients were able to walk in placebo and DexM groups, respectively (p=0.46). Intravenous DexM was associated with bradycardia, hypotension and longer recovery room stay (p&lt;0.05\u2009for all comparisons).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In a multimodal analgesic regimen, addition of systemic DexM (2\u2009\u00b5g\/kg) to systemic dexamethasone does not prolong the analgesic duration of quadruple nerve block with ropivacaine 0.32% after TKA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT03834129\">NCT03834129<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rapm-2020-101749","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T17:11:47Z","timestamp":1603300307000},"page":"104-110","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["Total knee arthroplasty under quadruple nerve block with ropivacaine 0.32%: effect of addition of intravenous dexmedetomidine to intravenous dexamethasone on analgesic duration"],"prefix":"10.1136","volume":"46","clinical-trial-number":[{"clinical-trial-number":"nct03834129","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Clement","family":"Chassery","sequence":"first","affiliation":[{"name":"Anesthesia, Clinique Medipole Garonne, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Marty","sequence":"additional","affiliation":[{"name":"Anesthesia, Clinique Medipole Garonne, Toulouse, 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