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Year : 2019  |  Volume : 17  |  Issue : 4  |  Page : 378-384

Efficacy of ultrasound-guided fascia iliaca compartment block with ropivacaine and dexmedetomidine for postoperative analgesia in hip arthroplasty

Department of Anaesthesia and Intensive Care, Faculty of Medicine, Al Azhar University, Cairo, Egypt

Correspondence Address:
Mostafa M Sabra
Ain Shams Al-Gharbia, Almashroae Street, Arafa Tower, 12273
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/AZMJ.AZMJ_101_19

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Background Suprainguinal fascia iliaca block (FICB) has been reported to provide effective postoperative analgesia in patients with femur fracture. This study aimed to evaluate the effectiveness of FICB with ropivacaine and dexmedetomidine for postoperative analgesia in hip arthroplasty. Patients and methods This prospective, double-blinded, randomized, controlled, clinical study was conducted on 57 patients with American Society of Anesthesiology physical status I–II, aged 50–70 years, undergoing elective hip arthroplasty. Subarachnoid block was given at the L3-4 interspace, and then the patients were divided into three groups according to the drug given in the suprainguinal fascia iliaca after subarachnoid block and before skin incision: group C received 40 ml normal saline, group R received 40 ml ropivacaine 0.2%, and group D received a mixture of dexmedetomidine 2 μg/kg diluted in 0.2% ropivacaine with 40 ml total volume. The primary outcome was evaluation of postoperative analgesia using numerical rating scale, recorded at 30 min and at 1, 3, 6, 9, 12, 15, 18, 21, and 24 h. Analgesic consumption and first analgesic request were the secondary outcomes. Results Numerical rating scale scores were significantly higher in group C when compared with groups R and D, at the 1, 3, and 6h. Postoperative pethidine consumption during the first 24 h was found to be significantly less in group R and group D when compared with group C. There was a statistically significant difference in the group D when compared with group C and group R, with less number of patients who required rescue analgesic in 24 h and prolonged time for first request of rescue analgesic. Conclusion Addition of dexmedetomidine to ropivacaine in FICB was efficacious in decreasing severity of pain, decreasing total analgesic consumption during the first 24 h, and prolonging the time for first request of analgesia in the postoperative period for patients undergoing hip arthroplasty.

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