Dexamethasone as adjuvant to ropivacaine in pre- operative ultrasound guided fascia iliaca compartment block for positioning patients with femoral fracture for central nervous blockade: A double blinded randomized comparative clinical study
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 6, Pages 2490-2496
AbstractBackground: Positioning for neuraxial blocks in proximal femur fracture is challenging, even slight overriding of the fracture end is intensely painful, Prior to neuraxial blockade, analgesia is provided by conventional modes of pain relief like NSAIDs, opioids and peripheral nerve blocks such as femoral nerve block, 3 in 1 block and Fascia iliaca compartment block, In this study we gave ultrasound guided Fascia iliaca compartment block and compared efficacy of block for positioning for spinal anesthesia with dexamethasone as adjuvant to ropivacaine in one group and only ropivacaine in another.
Methodology: In this double blind prospective, randomized comparative trial, 51 patients were randomly allocated to receive ultrasound guided fascia iliaca compartment block (FICB) with 38cc of 0.25% ropivacaine with 2cc saline in group A and 8mg(2cc) of dexamethasone with 38cc 0.25% ropivacaine in group B. Block was given 30 min before giving spinal anesthesia, oxygen saturation, systolic and diastolic blood pressure, Visual analogue scale (VAS) score for first 30 min and at the time of positioning was noted. Post-operatively monitoring was done half hourly till 6th hour, rescue analgesia time was noted (VAS>3)
Results: No significant difference was observed in both group in term of oxygen saturation, SBP, DBP, pulse rate and VAS scores in first 30 min and till 6th hour of post-operative period. While positioning for spinal anaesthesia pain scores were comparable in both the group with no significant difference observed (p>0.05). Mean rescue analgesia time for group A was 556.40±68.184 SD while for group B it was 616.15±71.447 SD min which was significantly higher (P=0.004).
Conclusion: USG guided FICB is easy to perform block and give excellent analgesia for positioning and mobilisation of femur fracture patients pre and post operatively both, and dexamethasone as adjuvant to 0.25% ropivavaine prolong its local anaesthetic effect significantly.
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