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ORIGINAL ARTICLE
Year : 2020  |  Volume : 9  |  Issue : 3  |  Page : 233-239

Comparison of preemptive analgesia with bupivacaine versus bupivacaine-dexmedetomidine in femoral block for fracture femur


Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil University, Pimpri, Pune, Maharashtra, India

Correspondence Address:
Dr. Aparna Bagle
Department of Anaesthesiology, Dr. D. Y. Patil Medical College, Dr. D. Y. Patil University, Pimpri, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhas.IJHAS_4_20

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BACKGROUND: Patients with fracture femur experience very severe pain and anxiety. These patients require adequate analgesia to allow radiological, orthopedic, and other procedures. An ideal analgesic technique should provide pain relief without altering consciousness. Femoral nerve block (FNB) has been proved very effective in providing satisfactory analgesia in fracture femur patients. Dexmedetomidine has analgesic property when used as an adjuvant in regional anesthesia. MATERIALS AND METHODS: This prospective, double-blind randomized comparative study was conducted on sixty American Society of Anesthesiologists I and II patients scheduled for elective fracture femur surgeries. They were divided into equal groups of thirty patients. FNB was given 15 min prior to spinal anesthesia. Group B received injection 0.25% bupivacaine 20 ml + 0.5 ml normal saline in FNB, while Group D received injection 0.25% bupivacaine 20 ml + injection. Dexmedetomidine 1 μg/kg, making a total volume of 0.5 ml. Hemodynamic variables, Visual Analog Score (VAS) score, and duration of analgesia were recorded from baseline till the end of surgery and 2 h postoperatively. Statistical analysis was done using SPSS version 20.0 (IBM software product, USA). RESULTS: Duration of analgesia for Group B was 5.37 ± 0.56 h and for Group D was 6.63 ± 0.86 h. Duration of analgesia was prolonged in Group D. Fall in VAS was significantly higher in Group D after 10 min of femoral block compared to Group B. Although changes in heart rate, systolic blood pressure, and mean arterial pressure were statistically significant in both the groups, patients were hemodynamically stable. CONCLUSION: Addition of dexmedetomidine in a dose of 1 μg/kg to bupivacaine 0.25% in FNB effectively reduces pain associated with positioning for spinal anaesthesia and prolong the duration of analgesia and without significant hemodynamic alteration.


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