Hiệu quả giảm đau sau phẫu thuật nội soi tái tạo dây chằng chéo trước của gây tê ống cơ khép bằng bupivacain kết hợp với dexamethason tĩnh mạch tại Bệnh viện Thành phố Thủ Đức năm 2023–2024

Postoperative pain remains a significant challenge following arthroscopic anterior cruciate ligament (ACL) reconstruction, often impeding early rehabilitation and patient comfort. While the adductor canal block (ACB) using bupivacaine is an established and effective regional anesthesia technique for managing such pain, there is a continuous effort to optimize its efficacy and duration. This study addresses this critical clinical need by investigating whether the addition of intravenous dexamethasone can further enhance the analgesic benefits of bupivacaine-based ACB in patients undergoing ACL reconstruction. Understanding superior pain management strategies is crucial for improving patient outcomes and accelerating recovery trajectories.

Anesthesiologists, orthopedic surgeons, pain management specialists, and researchers involved in regional anesthesia and postoperative care for orthopedic surgeries, particularly ACL reconstruction.

This randomized clinical trial aimed to evaluate the enhanced postoperative analgesic efficacy of an adductor canal block (ACB) using 0.25% bupivacaine when combined with 8 mg of intravenous dexamethasone, compared to bupivacaine alone, in patients undergoing arthroscopic anterior cruciate ligament (ACL) reconstruction. Conducted at Thu Duc General Hospital from April 2023 to August 2024, the study involved 83 patients randomly assigned to two groups: one receiving bupivacaine plus dexamethasone (BD group) and the other receiving bupivacaine alone (B group). Key outcomes included Visual Analog Scale (VAS) pain scores at rest and during movement, morphine consumption, and adverse events. The results demonstrated that the BD group exhibited significantly lower VAS scores from 6 to 24 hours postoperatively compared to the B group (p < 0.05). Specifically, the incidence of moderate-to-severe pain at rest was 2.5% in the BD group versus 20.5% in the B group, and during movement, it was 17.3% in BD compared to 53.4% in B (p < 0.05). No severe complications were observed in either group. These findings indicate that the adductor canal block with bupivacaine combined with intravenous dexamethasone significantly enhances and prolongs postoperative analgesia, offering a safe and superior pain management solution. This technique is therefore recommended for clinical practice in ACL reconstruction arthroscopy, improving patient comfort and recovery.