Impact of Adjuvants on Post-Spinal Urinary Retention: A Comparative Study of Dexmedetomidine and Fentanyl in Knee Arthroscopy.
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Abd Elsalam Tamer F, Almonayery Ibrahim Doaa Mohamed, Ahmed Samia Sayed, Abdel-Aziz Marwa Mahmoud, Elshehawy Naglaa Abdelmomen, Bakry Mostafa R, Ali Warda Demerdash Khalifa, Gaml Samah Abdelaty Soliman, Mohammad Suzan Mohammad Abdelkareem, Abdelaziz Fatma Mohamed, Abosaifa Hend Mostafa, Eldeeb Amira Sobhy Khalil, Ali Wafaa Ali Abd Elhadi, Salem Eman A, Eldesoky Gehan Abd Elrh-Man, Mohamad Taiseer Abdulnaser, Lashin Amira Ibrahim, Khalil Hanaa A M, Morsy Hayam Shaaban Soliman, Eid Marwa Ibrahim, Elsaied Rasha Lotfy, Hassan Ain Elmarwa Abdelmonam Abdallah, Khalil Anas Fawzy, Khalifa Osama Yehia A, Elsayed Abdelkarem Hussiny Ismail
Аннотация
OBJECTIVE: To evaluate and compare the incidence of postoperative urinary retention and analgesic profiles associated with intrathecal dex-medetomidine and fentanyl when administered alongside bupivacaine in patients undergoing knee arthroscopy.
MATERIAL AND METHODS: A prospective, randomized, double-blind trial was conducted involving 70 ASA I-II patients undergoing knee arthroscopy under spinal anesthesia. Patients were randomly assigned to receive intrathecal bupivacaine with either dexmedetomidine (Group D) or fentanyl (Group F). Primary outcomes included the incidence of POUR and need for catheterization. Secondary outcomes were block characteristics, pain scores, and adverse effects.
RESULTS: Group D exhibited significantly lower incidence of POUR (5.7%) compared to Group F (28.6%, p = 0.011). Dexmedetomidine also resulted in faster onset of sensory block, longer motor block duration, and lower postoperative VAS pain scores. No significant difference in catheterization rates or adverse events was observed between groups.
CONCLUSIONS: Intrathecal dexmedetomidine is superior to fentanyl in reducing POUR and enhancing postoperative analgesia for knee arthroscopy. Its use may optimize recovery protocols, particularly in ambulatory orthopedic surgeries.