Key result
Administration of intravenous dexamethasone to fascia iliaca compartment block increased time to first analgesic request and decreased 24-hour analgesic consumption.
Why the study?
Although dexamethasone is added to peripheral nerve blocks to increase analgesic efficacy, its effect when added to fascia iliaca compartment nerve block was not known.
Does intravenous dexamethasone added to fascia iliaca compartment block improve postoperative analgesia in patients undergoing open reduction and internal fixation of femoral fracture?
RCT (n=60)
randomized
No
Does intravenous dexamethasone added to fascia iliaca compartment block improve postoperative analgesia in patients undergoing open reduction and internal fixation of femoral fracture?
Adding 8 mg intravenous dexamethasone to fascia iliaca compartment block improves postoperative analgesia and reduces opioid consumption in patients undergoing femoral fracture surgery.
Answers are grounded in this paper and cite their sources.
May warrant IV dexamethasone with fascia iliaca block to curb opioids after femoral fixation; extends steroid adjunct data in orthopedic regional anesthesia.
Background: Fascia iliaca compartment nerve block is used for open reduction and internal fixation surgery of femoral fracture. Though dexamethasone is added to peripheral nerve block to increase analgesia efficacy but its effect on fascia iliaca is not known. Method: A randomized control trial conducted in Hawassa University Comprehensive Specialized Hospital by recruiting 60 patients. Mann Whitney U test was used for distribution free data and independent t-test was used for normally distributed numeric data respectively. Categorical variable between two groups were analyzed using chi-square or fisher exact test. Data was expressed in terms of mean ± standard deviation for normally distributed data or median (inter quartile range) for skewed data. p -value <0.05 is considered statically significant. Results: There were statistically significant differences between the groups in time to first analgesia request p-value of = 0.003, tramadol, diclofenac and morphine consumption with p-value of, 0.017, 0.036 and 0.046 respectively. Regarding pain severity score a statistical significant differences were found at 6 and 12 h with p-values of 0.039 and 0.024 respectively while there was no statically significant difference in incidence of postoperative nausea vomiting (p = 0.448). Conclusion: Administration of 8 mg intravenous dexamethasone to fascia iliaca compartment block increases time to first analgesic request, decrease total 24 h analgesic consumption. Trial registration number: PACTR201910904223565. Highlights:
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Abate et al. (2020) conducted an RCT in femoral fracture undergoing open reduction and internal fixation surgery (n=60). intravenous dexamethasone vs. control group was evaluated on time to first analgesia request (p=0.003). Administration of intravenous dexamethasone to fascia iliaca compartment block increased time to first analgesic request and decreased 24-hour analgesic consumption.
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