{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:23:55Z","timestamp":1783013035824,"version":"3.54.6"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Postoperative pain management is critical for recovery following total knee replacement (TKR). Significant pain following surgery is linked to TKR, and this discomfort might have a negative impact on the patient\u2019s satisfaction, length of stay, and functional recovery. The adductor canal block (ACB) is preferred for its motor-sparing properties. This study compared the analgesic efficacy of ketamine and dexmedetomidine as adjuvants to ropivacaine infusion in ACB for patients undergoing unilateral TKR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this prospective, randomized, comparative study, 44 patients (American Society of Anesthesiologists I\u2013III) were divided into two equal groups. All received spinal anesthesia followed by an ultrasound-guided ACB with a catheter. Group A received 0.2% ropivacaine with ketamine (1 mg\/kg) infusion, and Group B received 0.2% ropivacaine with dexmedetomidine (1 \u03bcg\/kg) infusion at 8\u201310 mL\/h for 24 h. Primary outcomes included a comparison of the requirement for rescue analgesia, while secondary outcomes included a comparison of pain scores, hemodynamic stability, and motor blockade.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The requirement for rescue analgesia was significantly higher in Group A (54.54%) compared to Group B (18.2%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.012). While numerical pain scores were generally comparable, Group B showed significantly lower pain at the 8\n                      <jats:sup>th<\/jats:sup>\n                      h (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.045). Both groups maintained hemodynamic stability and demonstrated preserved motor power. Postoperative vomiting was significantly more frequent in Group A (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.035).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Dexmedetomidine (1 \u03bcg\/kg) is a more effective adjuvant than ketamine (1 mg\/kg) for ropivacaine-based ACB, offering improved analgesia without adverse hemodynamic or motor effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/aam.aam_396_26","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:58:31Z","timestamp":1783011511000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Analgesic Effects of Ketamine versus Dexmedetomidine as an Adjuvant to 0.2% Ropivacaine Infusion in Adductor Canal Block for Postoperative Analgesia following Unilateral Total Knee Replacement Surgery"],"prefix":"10.4103","author":[{"given":"Sahla","family":"Shamsudheen","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gokuldas Sekhara","family":"Menon","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitu","family":"Puthenveettil","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Critical Care, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,2]]},"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.4103\/aam.aam_396_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:58:32Z","timestamp":1783011512000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.4103\/aam.aam_396_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,2]]},"references-count":0,"URL":"https:\/\/doi.org\/10.4103\/aam.aam_396_26","relation":{},"ISSN":["1596-3519","0975-5764"],"issn-type":[{"value":"1596-3519","type":"print"},{"value":"0975-5764","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,2]]},"assertion":[{"value":"2026-04-07","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-20","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}