Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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A Clinical Comparison of Dexamethasone and Dexmedetomidine as Adjuvant to Ropivacaine in Fascia Iliaca Compartment Block in Patients with Hip and Femur Fracture under Spinal Anaesthesia
Esita Dutta, Manabendra Sarkar, Dibas Saha and Atif Ali
Page: 352-360 | Received 26 Jan 2024, Published online: 15 Mar 2024
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Abstract
One of the basic biological phenomena is pain. According to the International Association for the Study of Pain, Pain is an unpleasant sensory and emotional experience connected to tissue damage that has occurred or may occur. Positioning for spinal anaesthesia is challenging in hip and femur fracture patients. Fascia iliaca compartment block (FICB) is a low skilled technique that helps positioning and provide post operative analgesia. Dexamethasone and Dexmedetomidine are adjuvant that prolong analgesia. In order to evaluate any potential adverse effects of Dexamethasone and Dexmedetomidine, hemodynamic measures such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and oxygen saturation should be compared. Assessment of pain during positioning of patient for spinal anaesthesia following landmark guided Fascia iliaca compartment block (FICB) and assessment of the duration of post operative analgesia following surgery as measured by the Numerical Rating Scale (NRS score <3) are primary aim of our study. This study was prospective, randomized, single blind controlled study. This study was conducted for one and half years (March 2020‐August 2021) at Nil Ratan Sircar Medical College and Hospital. The study was performed in the patients posted for hip and femur fracture under spinal anaesthesia. The study began after obtaining permission from ethics committee of this institute and also after obtaining approval of The West Bengal University of Health Sciences. Total 60 patients were included in this study. 30 patients were given FICB with 30ml of 0.25% Ropivacaine with 8mg of Dexamethasone and rest 30 patients received FICB with 0.25% Ropivacaine with 100ug of Dexmedetomidine. Data were analysed using SPSS V.24 software. Categorical data were processed by frequencies and proportion, whereas continuous data were processed by mean standard deviation. Chi square test used for qualitative data and Student t test for quantitative data as tests of significance, considering P<0.05 as statistically significant. In patients of Group A, the mean amount of rescue analgesics required in first twenty four (24 hour) post‐operative hour was 105±37.4 mg of injection Diclofenac i.m. In Group B patients the mean Amount of rescue analgesic was 75±4.7 mg of injection Diclofenac i.m. Distribution of mean Amount of rescue analgesic between the Groups was statistically significant (p<0.0001). The total duration of post operative analgesia between 2 groups was statistically significant (Group A 678±28.2 minutes and in group B 930.7±30 minutes and p<0.000)). In Group B, 1 patient had nausea, 1 patient had Bradycardia and 2 patients had hypotension. Association of Adverse effects within groups was not statistically significant (p = 0.232). Patients with hip and femur fractures experience less discomfort when positioned for spinal anaesthesia after using the Fascia iliaca compartment block (FICB). For Fascia iliaca compartment block (FICB) in patients with hip and femur fractures, adding of Dexamethasone or Dexmedetomidine as adjuvant to Ropivacaine prolongs post‐operative analgesia. Also addition of Dexmedetomidine with Ropivacaine offers longer postoperative analgesia than Ropivacaine with Dexamethasone.
How to cite this article:
Esita Dutta, Manabendra Sarkar, Dibas Saha and Atif Ali. A Clinical Comparison of Dexamethasone and Dexmedetomidine as Adjuvant to Ropivacaine in Fascia Iliaca Compartment Block in Patients with Hip and Femur Fracture under Spinal Anaesthesia .
DOI: https://doi.org/10.36478/10.59218/makrjms.2024.2.352.360
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2024.2.352.360