A COMPARATIVE STUDY OF FEMORAL NERVE BLOCK (WITH AND WITHOUT DEXAMETHASONE) VERSUS INTRAVENOUS FENTANYL FOR POSITIONING AND DURATION OF POSTOPERATIVE ANALGESIA IN FRACTURE FEMUR PATIENT UNDER SPINAL ANESTHESIA

SUSHREE DAS; SURABHI WAHI; RANJITA ACHARYA; MADHUSMITA PATRO

doi:10.22159/ajpcr.2025v18i1.53416

Authors

SUSHREE DAS Department of Anaesthesia IMS and SUM Hospital, Bhubaneswar, Odisha, India https://orcid.org/0000-0002-2926-7847
SURABHI WAHI Department of Anesthesiology and Pain Medicine, Rama Medical College, Hapur, Uttar Pradesh, India
RANJITA ACHARYA Department of Anaesthesiology and Pain Medicine, IMS and Sum Hospital, Bhubaneswar, Odisha, India.
MADHUSMITA PATRO Department of Anaesthesiology and Pain Medicine, IMS and Sum Hospital, Bhubaneswar, Odisha, India.3Department of Anaesthesiology and Pain Medicine, IMS and Sum Hospital, Bhubaneswar, Odisha, India. https://orcid.org/0000-0003-2779-3672

DOI:

https://doi.org/10.22159/ajpcr.2025v18i1.53416

Keywords:

Femoral nerve block, Spinal anesthesia,Spinal anesthesia,, Fentanyl, Dexamethasone, Pain, Rescue analgesia, Positioning, Post-operative pain

Abstract

Objectives: The preferred technique for fracture femur operation is spinal anesthesia (SA). During position for SA, femoral nerve block (FNB) and intravenous (IV) fentanyl are used to decrease the pain. The analgesia provided by FNB with dexamethasone (FNBD), FNB only, and intra-venous fentanyl (FENT) was compared before positioning in patients undergoing femur fracture surgery.

Methods: 90 patients of fracture femurs were randomized into three Groups A (FNBD), B (FNB), and C (FENT). The FNBD and FNB group patients received drug using ultrasound-guided method 5 min before positioning. In FNB, 10 mL of 2% lidocaine with adrenaline (1:200,000) with 10 mL of bupivacaine was injected, 8 mg of dexamethasone was added in FNDB group, and in the FNET group, received IV fentanyl 1 μg/kg 5 min before positioning. Spinal was given and pain score at baseline, 5, 15, and 30 min recorded.

Results: The mean VAS was lowest for Group A and highest for Group C. The Quality of patient positioning is best in Group A and lowest in Group C and p value between Group A and C is <0.0001. The sample size came to be 30 per group by taking alpha as 5%, power of study as 95% and standard deviation as 3.

Conclusion: Patient satisfaction, positioning during spinal, and analgesia were better with FNB with or without dexamethasone than IV fentanyl

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