Key result
Addition of dexmedetomidine to ropivacaine for fascia iliaca compartment block significantly prolonged the time to first rescue analgesia to 13.03 hours compared to 5.94 hours with ropivacaine alone.
Why the study?
Patients with femur fracture experience severe post-operative pain, and fascia iliaca compartment block is an effective approach for analgesia, but the comparative efficacy of adding dexmedetomidine versus dexamethasone to ropivacaine needed evaluation.
Does the addition of dexmedetomidine or dexamethasone to ropivacaine in fascia iliaca compartment block improve post-operative pain relief in patients undergoing femur fracture surgery?
RCT (n=105)
Double-blind
Envelope method
No
Does the addition of dexmedetomidine or dexamethasone to ropivacaine in fascia iliaca compartment block improve post-operative pain relief in patients undergoing femur fracture surgery?
Absolute Event Rate: 13.03% vs 5.94%
p-value: p=<0.001
The addition of dexmedetomidine or dexamethasone to ropivacaine for fascia iliaca compartment block significantly prolongs post-operative analgesia and reduces pain scores compared to ropivacaine alone in femur fracture patients.
Supports adjunct dexmedetomidine in FICB for femur fracture analgesia; extends RCT data on regional adjuvants.
Background: Patients with femur fracture experience severe post-operative pain. Fascia iliaca compartment block (FICB) is a safe and effective approach for providing post-operative analgesia. Aims and Objectives: The aim of the study was to compare the post-operative pain relief with dexmedetomidine and dexamethasone with ropivacaine in FICB. Materials and Methods: This prospective, double-blinded, randomized controlled, and clinical study was done on 105 patients, with ASA physical status I-II, aged between 18 and 70 years, undergoing surgery for femur fracture. Patients were randomly allocated into three groups. All patients received FICB by landmark technique before spinal anesthesia. Group A patients received 38 mL of 0.25% ropivacaine and dexmedetomidine, Group B received 38 mL of 0.25% ropivacaine and dexamethasone and Group C received 38 mL of 0.25% ropivacaine. Patients were assessed for analgesia during positioning and post-operative period using visual analog scale (VAS). Hemodynamic parameters and time for first rescue analgesia were recorded. Results: The mean VAS score at 6 h after surgery was 0.74±0.95 in Group A, in Group B 2.26±0.95, and in Group C was 4.23±1.17, which was statistically significant (P<0.05). The time for first rescue analgesia was 13.03±1.79 h in Group-A, 8.31±1.11 h in Group B and 5.94±0.87 h in Group C (P<0.001). Conclusion: Addition of dexmedetomidine or dexamethasone to ropivacaine for FICB in femur fracture patients prolongs post-operative analgesia compared to ropivacaine alone.
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Bansal et al. (2023) conducted an RCT in Femur fracture (n=105). Ropivacaine with dexmedetomidine vs. Ropivacaine alone (38 mL of 0.25%) was evaluated on Time to first rescue analgesia (p=<0.001). Addition of dexmedetomidine to ropivacaine for fascia iliaca compartment block significantly prolonged the time to first rescue analgesia to 13.03 hours compared to 5.94 hours with ropivacaine alone.
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