Efficacy of dexmedetomidine as an adjuvant to ropivacaine in femoral nerve block for acute pain relief in patients with fracture of femoral shaft and neck

Abstract

Background: The patients admitted to the emergency department with the fracture of femoral shaft and neck have severe pain, and these patients require adequate analgesia to allow radiological, orthopedic, and other procedures to be performed. Femoral nerve block (FNB) has proved to be effective in providing satisfactory analgesia. Dexmedetomidine has analgesic and sedative property when used as an adjuvant in regional anesthesia. The aim of this study was to evaluate the efficacy of dexmedetomidine added to ropivacaine in FNB with regard to onset, duration, efficacy of analgesia, and patient acceptance. Materials and Methods: Sixty patients of American Society of Anesthesiologists grade I and II of either sex, aged 18–60 years, who presented with the fracture of femoral shaft and neck in the emergency department were randomly divided into two groups of 30 patients each: group D (n = 30): patients were administered 15 mL ropivacaine (0.5%) plus dexmedetomidine 1 μg/kg body weight (total volume, 16 mL) and group R (n = 30): patients were administered 15 mL ropivacaine (0.5%) plus 1 mL saline. Results: The onset of analgesia was much earlier in group D (3.77 ± 0.84 min) than that in group R (4.6 ± 1.1 min). The mean duration of analgesia was prolonged in group D (744.33 ± 179.6 min) than that in group R (263 ± 67 min). The fall in visual analog scale score was significantly higher in group D in comparison to group R. The patient acceptance after 24 h of the procedure was better in group D. Conclusion: We concluded that the addition of dexmedetomidine to ropivacaine in FNB provides early onset of analgesia, prolongs the duration of analgesia, improves the quality of analgesia, and has better patient acceptance.

Keywords

• Dexmedetomidine
• femoral nerve block
• ropivacaine
• visual analog scale scores