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Evaluation of local anaesthetic with adjuvants for postoperative analgesia through ultrasound-guided Fascia Iliaca compartment block in hip procedures

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Original Article

Author Details : Prem Kumar, Thamizhmathi Thangaraju*, Monica Daisy T

Volume : 11, Issue : 4, Year : 2024

Article Page : 538-544

https://doi.org/10.18231/j.ijca.2024.097

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Abstract

Background: Hip surgeries often result in significant postoperative pain, affecting early mobilization and rehabilitation. The Fascia Iliaca compartment block (FICB), guided by ultrasound, is a regional anaesthesia technique that can reduce this pain. The addition of adjuvants to local anaesthetics may enhance the block's duration and quality. This study evaluates the efficacy and safety of adding dexamethasone and dexmedetomidine as adjuvants to 0.25% ropivacaine for postoperative analgesia in hip procedures.
The study aims to compare the duration and quality of postoperative analgesia of ropivacaine and ropivacaine with additives such as dexmedetomidine and dexamethasone for ultrasound-guided fascia iliaca compartment block in patients undergoing three different lower limb orthopaedic procedures.
Primary Objective: To assess and compare the duration of post-operative analgesia between 0.25% ropivacaine, ropivacaine with dexmedetomidine and ropivacaine with dexamethasone.
Secondary Objective : To assess and compare the time of requirement of rescue analgesia between the three groups
Materials and Methods: This prospective, randomised, double-blind, placebo-controlled trial involved 60 patients undergoing hip surgeries including Total hip replacement (THR), Dynamic Hip Screw (DHS), and Proximal Femoral Nailing (PFN) divided equally into three groups. Group A received 0.25% ropivacaine with dexamethasone, Group B received 0.25% ropivacaine with dexmedetomidine, and Group C received 0.25% ropivacaine with a placebo. The primary outcomes measured were the duration of analgesia and postoperative pain scores. Secondary outcomes included the need for rescue analgesia and the incidence of side effects.
Results: Patients who received dexmedetomidine or dexamethasone experienced significantly longer durations of analgesia and lower postoperative pain scores in the first 24 hours compared to those who received the placebo. Additionally, the need for rescue analgesia was reduced, and the incidence of side effects was comparable between the groups receiving adjuvants and the placebo group.
Conclusion: The order of better analgesia and prolonged duration was best with ropivacaine and dexmedetomidine, next best with ropivacaine and dexamethasone when compared to ropivacaine without adjuvant.
 

Keywords: Analgesia, Dexamethasone, Dexmedetomidine, Anesthetic adjuvants, Postoperative period.

How to cite : Kumar P, Thangaraju T, Monica Daisy T, Evaluation of local anaesthetic with adjuvants for postoperative analgesia through ultrasound-guided Fascia Iliaca compartment block in hip procedures. Indian J Clin Anaesth 2024;11(4):538-544

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