0.25% Bupivacaine with 50mcg Clonidine Versus 0.25% Bupivacaine with 8mg Dexamethasone Versus 0.25% Bupivacaine Alone as Adjuvant on Fascia Iliaca Compartment Block (FICB) in Femoral Fractures by Internal Fixation and Open Reduction Procedures

Introduction: Femoral fractures result in intense discomfort during movement when setting for anaesthetic procedures. The fascia iliaca compartment nerve block (FICB) is a frequently utilized pain management method that efficiently delivers analgesia. Dexamethasone and clonidine serve as effective adjuvants to local anesthetics, providing significant analgesic benefits with few side effects. This study aimed to evaluate the effectiveness of bupivacaine in conjunction with clonidine, bupivacaine with dexamethasone, and bupivacaine alone for fascia iliaca compartment block in femoral fracture cases. Materials and Methods: Ninety-six cases undergoing proximal femoral operations were randomly allocated into three study groups (n=32 each). Group B was administered 0.25% bupivacaine combined with 2 ml of normal saline, group BC received 0.25% bupivacaine with 50 mcg of clonidine, and group BD was given 0.25% bupivacaine with 8 mg of dexamethasone. Haemodynamic parameters, VAS score, supplementary analgesic requirements, and analgesia duration were evaluated. Results: The mean differences in hemodynamic parameters were statistically significant at 15, 30, 45, 60, and 90 minutes (p<0.05). The needed analgesic dosages were 4.99 in group B, 3.05 in group BC, and 2.93 in group BD. The cohort administered bupivacaine in conjunction with dexamethasone (13.99 hours) demonstrated a prolonged analgesic effect, succeeded by Group BC (12.67 hours) and Group B (6.23 hours). The mean VAS score exhibited statistical significance between the study groups (p<0.05). Conclusion: The combination of 0.25% bupivacaine with 8mg Dexamethasone provided better analgesic duration and required less rescue analgesia on the first postoperative day in patients having femoral operations under FICB compared to 0.25% bupivacaine with 50mcg clonidine.