0.25% bupivacaine with 8mg dexamethasone and 50mcg clonidine as adjuvant on fascia iliaca compartment block in open reduction and internal fixation surgeries to femoral fractures: A prospective randomized study

Abstract

Background: Fascia iliaca compartment nerve block (FICB) is commonly preferred pain management technique in femoral fractures. Dexamethasone and clonidine as adjuvants to local anesthetics has good analgesic effect with limited adverse effect. This study was designed to assess the efficacy of bupivacaine with clonidine, bupivacaine with dexamethasone and bupivacaine alone in fascia iliaca compartment block in cases with femoral fractures. Materials and Methods: The present prospective randomized study included a total of 120 cases undergoing proximal femoral surgeries under subarachnoid block above 21 years. The study cases were randomly divided into three study groups i.e. 40 participants in each groups. Group 1 received 0.25% bupivacaine with 2 ml normal saline, group 2 received 0.25% bupivacaine with 50mcg clonidine and group 3 received with 0.25% bupivacaine with 8mg dexamethasone. Parameters such as heart rate (HR), mean arterial pressure (MAP), systolic blood pressure (SBP), diastolic blood pressure (DBP), oxygen saturation levels and VAS score was monitored and recorded. Results: The mean difference of heart rate between the study groups was statistically not significant (p>0.005). The mean SBP, DBP and VAS score was comparable between study groups. The mean analgesic duration in group 1 was 6.01 hours, in group 2 was 13.58 hours and in group 3 was 14.44 hours. The mean difference of rescue analgesia requirement and duration of rescue analgesia was statistically significant. No adverse effects towards drugs were noticed. Conclusion: 0.25% bupivacaine with 8mg Dexamethasone had better analgesic duration and require minimal rescue analgesia in the first postoperative day than 0.25% bupivacaine with 50mcg clonidine in cases undergoing femoral surgeries under FICB.