Why the study?
Spinal anesthesia is preferred for femur fracture operations, but positioning causes pain; the analgesia provided by femoral nerve block with dexamethasone, femoral nerve block alone, and intravenous fentanyl before positioning required comparison.
Does femoral nerve block with or without dexamethasone improve pain and positioning quality compared to intravenous fentanyl in patients with femur fractures undergoing spinal anesthesia?
Does femoral nerve block with or without dexamethasone improve pain and positioning quality compared to intravenous fentanyl in patients with femur fractures undergoing spinal anesthesia?
Femoral nerve block, particularly with dexamethasone, provides superior analgesia and positioning conditions compared to intravenous fentanyl for patients with femur fractures undergoing spinal anesthesia.
FNB (with/without dexamethasone) may ease positioning and reduce pain versus fentanyl; leaves open optimal regimen and practice change.
Objectives: The preferred technique for fracture femur operation is spinal anesthesia (SA). During position for SA, femoral nerve block (FNB) and intravenous (IV) fentanyl are used to decrease the pain. The analgesia provided by FNB with dexamethasone (FNBD), FNB only, and intra-venous fentanyl (FENT) was compared before positioning in patients undergoing femur fracture surgery. Methods: 90 patients of fracture femurs were randomized into three Groups A (FNBD), B (FNB), and C (FENT). The FNBD and FNB group patients received drug using ultrasound-guided method 5 min before positioning. In FNB, 10 mL of 2% lidocaine with adrenaline (1:200,000) with 10 mL of bupivacaine was injected, 8 mg of dexamethasone was added in FNDB group, and in the FNET group, received IV fentanyl 1 μg/kg 5 min before positioning. Spinal was given and pain score at baseline, 5, 15, and 30 min recorded. Results: The mean VAS was lowest for Group A and highest for Group C. The Quality of patient positioning is best in Group A and lowest in Group C and p value between Group A and C is <0.0001. The sample size came to be 30 per group by taking alpha as 5%, power of study as 95% and standard deviation as 3. Conclusion: Patient satisfaction, positioning during spinal, and analgesia were better with FNB with or without dexamethasone than IV fentanyl
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Das et al. (2025) studied this question.
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