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CONTEXT: Positioning fracture femur cases for sub arachnoid block (SAB) is challenging. Fascia iliaca compartment block (FICB) is low skilled, helps positioning, and provides analgesia. Dexmedetomidine as an adjuvant prolongs analgesia. AIMS: The aims were to study and compare FICB with bupivacaine and bupivacaine with dexmedetomidine in fracture femur cases with regard to positioning during SAB, duration of analgesia in terms of Visual Analog Scale (VAS), Numerical Rating Scale (NRS), and Patient Satisfaction Score, and assess side effects. SETTINGS AND DESIGN: This was a randomized, double-blind, prospective study. SUBJECTS AND METHODS: Sixty fracture femur patients were divided into two groups as follows: Group A: FICB with injection bupivacaine 0.25% 38 cubic centimeter (cc) + dexmedetomidine 0.5 μg/kg in 2 cc normal saline (NS) and Group B: FICB with injection bupivacaine 0.25% 38 cc + 2 cc NS. STATISTICAL ANALYSIS USED: < 0.05 as statistically significant. RESULTS: In Group A, mean VAS score at 5 min (min) was 3.7 ± 0.9 and in Group B it was 4.3 ± 0.7. Similarly, at 15 min, mean VAS score in Group A was 0.4 ± 0.6 and in Group B it was 1.9 ± 0.9. VAS score was significantly high in Group B at 5, 10, and 15 min. Mean time to rescue analgesia in Group A was 838.3 ± 82.7 min and in Group B it was 461.5 ± 36.6 min, which was significant. CONCLUSION: FICB ensures patient comfort during positioning for SAB and provides postoperative analgesia. Dexmedetomidine significantly prolongs postoperative analgesia.
Krishnamurthy et al. (Mon,) studied this question.