So sánh hiệu quả giảm đau của tê thần kinh đùi bằng bupivacain 0,25% phối hợp dexamethason đường tê thần kinh với dexamethason đường tĩnh mạch sau phẫu thuật nội soi tái tạo dây chằng chéo trước

Abstract

Objective: To compare the analgesic efficacy of femoral nerve block with 0.25% bupivacaine combined with perineural dexamethasone versus intravenous dexamethasone after athroscopic anterior cruciate ligament reconstruction (AACLR). Subject and method: From March to May 2025, 100 patients undergoing AACLR requiring postoperative analgesia were randomly allocated into two groups. Group 1 received femoral nerve block with 0.25% bupivacaine combined with 8mg perineural dexamethasone. Group 2 received femoral nerve block with 0.25% bupivacaine combined with 8mg intravenous dexamethasone. Outcomes included onset time of analgesia, duration of analgesia, and visual analog scale (VAS) scores at rest and during movement at 3, 6, 12, 24, 36, and 48 hours postoperatively, vital signs and adverse effects. Result: The onset of analgesia was faster in Group 1 compared with Group 2 (4.2 ± 2.5 minutes vs 6.5 ± 3.1 minutes, <0.05). The duration of analgesia was longer in Group 1 than in Group 2 (1412 ± 312 minutes vs 1238 ± 365 minutes, p<0.05). Group 1 had significantly lower VAS scores at 24 hours postoperatively. No cases of vascular puncture, local anesthetic toxicity, or neurological complications were observed. Conclusion: The addition of dexamethasone to bupivacaine in femoral nerve block prolongs postoperative analgesia compared with intravenous administration. Both routes were safe and associated with minimal adverse effects.