• Nikila Devarayasamudram Gopal and Dinesh Krishnamurthy.
• Department of Anaesthesiology, Sri Devaraj Urs Medical College, R L Jalappa Hospital, Kolar, Karnataka, India.
• Anesth Essays Res. 2018 Apr 1; 12 (2): 528-534.

ContextPositioning fracture femur cases for sub arachnoid block (SAB) is challenging. Fascia iliaca compartment block (FICB) is low skilled, helps positioning, and provides analgesia. Dexmedetomidine as an adjuvant prolongs analgesia.AimsThe aims were to study and compare FICB with bupivacaine and bupivacaine with dexmedetomidine in fracture femur cases with regard to positioning during SAB, duration of analgesia in terms of Visual Analog Scale (VAS), Numerical Rating Scale (NRS), and Patient Satisfaction Score, and assess side effects.Settings And DesignThis was a randomized, double-blind, prospective study.Subjects And MethodsSixty fracture femur patients were divided into two groups as follows: Group A: FICB with injection bupivacaine 0.25% 38 cubic centimeter (cc) + dexmedetomidine 0.5 μg/kg in 2 cc normal saline (NS) and Group B: FICB with injection bupivacaine 0.25% 38 cc + 2 cc NS.Statistical Analysis UsedData were analyzed using SPSS 22.0 software. Categorical data were processed by frequencies and proportions, whereas continuous data were processed by mean standard deviation. Chi-square test and independent t-test were used as tests of significance, considering P < 0.05 as statistically significant.ResultsIn Group A, mean VAS score at 5 min (min) was 3.7 ± 0.9 and in Group B it was 4.3 ± 0.7. Similarly, at 15 min, mean VAS score in Group A was 0.4 ± 0.6 and in Group B it was 1.9 ± 0.9. VAS score was significantly high in Group B at 5, 10, and 15 min. Mean time to rescue analgesia in Group A was 838.3 ± 82.7 min and in Group B it was 461.5 ± 36.6 min, which was significant.ConclusionFICB ensures patient comfort during positioning for SAB and provides postoperative analgesia. Dexmedetomidine significantly prolongs postoperative analgesia.

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