Editorial Commentary: Addition of Dexmedetomidine to Local Analgesia for Knee Arthroscopy

The search for the ideal pain management strategy after knee arthroscopy continues. For patients unable to receive regional anesthesia, peri-articular or intra-articular injections of local anesthetics with other medications offer a promising solution. Dexmedetomidine (a short-term sedative analgesic marketed under the names Dexdor and Precedex), when added to local anesthetics, may offer an increase in the length of time between surgery and the need for a rescue analgesic agent. Whether the addition of dexmedetomidine results in lower pain scores or decreased opioid consumption remains to be proven. Systemic effects of dexmedetomidine, such as sedation and hypotension, appear less likely to occur with intra-articular injections, suggesting a favorable safety profile. The effects of dexmedetomidine on chondrocytes, as well as the effects of combining medications in the intra-articular environment, are less well understood and should be a focus of further research. Similarly, there is still a need to identify the best patients, best procedures, best combination of medications, and best doses to optimize our approach to post-operative pain management via intra-articular injection.