Department of Anesthesiology and Reanimation, Hacettepe University School of Medicine, Sıhhiye, 06230, Ankara, Turkey.
Department of Histology and Embryology, Hacettepe University School of Medicine, Ankara, Turkey.
BMC Anesthesiol. 2020 Sep 17;20(1):237. doi: 10.1186/s12871-020-01148-x.
Intraarticular injections are widely used to provide pain relief after arthroscopic procedures and minimize the use of opioids. Dexmedetomidine has been proven to potentiate pain relief and postpone the demand for the first analgesic drug when it is used intraarticularly following arthroscopic knee procedures. However, the effects of dexmedetomidine on articular structures have not yet been evaluated. Our aim was to determine the effects of intraarticular dexmedetomidine injection on articular structures such as cartilage and synovium.
Animal study.
Twenty adult rats (Sprague-Dawley) were enrolled in the study. Following appropriate aseptic and anesthetic conditions, dexmedetomidine (100 mcg/ml) (0.25 ml) was injected into the right knee joint (the study group) and normal saline solution (0.25 ml) into the left knee joint (the control group) of the rats. Four rats were sacrificed from each group on days 1, 2, 7, 14, and 21, and knee joint samples were obtained. Histologists evaluated the articular and periarticular regions and the synovium using histological sections, and a five-point scale was used to grade the inflammatory changes in a blinded manner.
The groups were found to be similar in terms of median congestion scores, edema and inflammation scores, subintimal fibrosis, neutrophil activation and cartilage structure at each of the time intervals.
In our placebo-controlled, in vivo trial, the intraarticular use of dexmedetomidine seemed to be safe with respect to the studied histopathological parameters. However, complementary studies investigating the histopathological effects, analgesic dosage and adverse effects of dexmedetomidine on damaged articular structure models are needed.
关节内注射被广泛用于关节镜手术后缓解疼痛并减少阿片类药物的使用。右美托咪定已被证明可增强止痛效果，并在关节镜膝关节手术后关节内使用时推迟对第一止痛药物的需求。然而，右美托咪定对关节结构的影响尚未得到评估。我们的目的是确定关节内注射右美托咪定对软骨和滑膜等关节结构的影响。
动物研究。
将 20 只成年大鼠（Sprague-Dawley）纳入研究。在适当的无菌和麻醉条件下，将右美托咪定（100 mcg/ml）（0.25 ml）注射到大鼠右膝关节（研究组），将生理盐水溶液（0.25 ml）注射到左膝关节（对照组）。每组各有 4 只大鼠在第 1、2、7、14 和 21 天被处死，获取膝关节样本。组织学家使用组织切片评估关节和关节周围区域以及滑膜，并使用五分制对炎症变化进行盲法分级。
在每个时间点，两组的中位数充血评分、水肿和炎症评分、内膜下纤维化、中性粒细胞激活和软骨结构相似。
在我们的安慰剂对照、体内试验中，关节内使用右美托咪定似乎在研究的组织病理学参数方面是安全的。然而，需要进一步研究以评估右美托咪定对受损关节结构模型的组织病理学影响、镇痛剂量和不良反应。
