Efficacy of adding Dexmedetomidine in Fascia Iliaca Compartment Block to provide analgesia for positioning femur fracture patients before spinal anesthesia

Amin, Mohamed A.; Abdalla, Abdalla M; Soltan, Sabri A

doi:10.21608/aimj.2020.44250.1328

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…The alpha error level was set at 0.05, and the power was set at 0.80. The effect size was calculated based on earlier reports [11], [12] assuming a medium effect size difference of 0.3 in intraoperative hemodynamic stability and postoperative analgesia between the two groups (adding dexmedetomidine perineurally to bupivacaine in ultrasound-guided fascia iliaca block and intravenously infused dexmedetomidine) in patients undergoing hip arthroscopy. Based on this assumption, a sample size of at least 88 patients planning hip arthroscopy (44 patients per group) was sufficient to achieve the study objectives.…”

Section: Methodsmentioning

confidence: 99%

The efficacy of adding dexmedetomidine perineurally in fascia iliaca compartment block versus intravenously in hip arthroscopy: A randomized controlled trial

Ibrahim¹,

Elderh²,

Abdelsalam³

2023

Rev. chil. anest.

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Background: Stable hemodynamics in hip arthroscopy is one of the most important tasks. Recently, dexmedetomidine has been considered a safe analgesic and sedative adjuvant in different surgeries. Ultrasound-guided fascia iliaca compartment block (FICB) is a technique used to produce postoperative analgesia for hip surgery. FICB will be a promising technique for postoperative analgesia in hip arthroscopy. Objective: We designed a prospective, randomized, double-blind, parallel-group trial to evaluate the effect of administration of dexmedetomidine intravenously and perineurally on hemodynamic stability intraoperatively and on narcotics consumption postoperatively, as well as to evaluate the effect of dexmedetomidine as an adjuvant to FICB. Patients: A total of 88 patients scheduled for elective hip arthroscopy, aged 18 to 65 years, 70-80 kg, both sexes. Patients were randomized into Group A (intravenous Dexmedetomidine) and Group B (perineural Dexmedetomidine). The Main outcome measure was to detect effectiveness of dexmedetomidine infusion without loading dose in achieving intraoperative hemodynamic stability with minimal need for rescue agents and its analgesic effect postoperatively, if added to bupivacaine in fascia iliaca block. Results: Dexmedetomidine significantly maintained mean arterial blood pressure and heart rate (P-value <0.001); with lower intraoperative fentanyl consumption in group A (53.85 ± 13.87 µg) when compared to group B (150.00 ± 40.35 µg) and no significant difference between the two groups in VAS scores postoperatively. Conclusions: Dexmedetomidine infusion provided stable intraoperative hemodynamics in patients undergoing hip arthroscopy with reduced intraoperative narcotics requirement, while addition of dexmedetomidine to bupivacaine had no role in prolonging the effect of FICB.

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Section: Methodsmentioning

confidence: 99%

The efficacy of adding dexmedetomidine perineurally in fascia iliaca compartment block versus intravenously in hip arthroscopy: A randomized controlled trial

Ibrahim¹,

Elderh²,

Abdelsalam³

2023

Rev. chil. anest.

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“…Last year, Amin et al conducted an RCT to determine the efficacy of adding dexmedetomidine to the local anesthesia mixture for a FICB for positioning patients with a femur fracture for spinal anesthesia 52 . They added 80 µg dexmedetomidine to 40 ml bupivacaine 0.25%.…”

Section: Adjuvant Drugs To Regional Blocksmentioning

confidence: 99%

Pain management after hip fracture repair surgery: a systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations

Pissens,

Cavens,

Joshi

et al. 2024

Acta Anaest Belg

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Hip fracture is associated with moderate-to-severe postoperative pain, which can influence postoperative recovery and length of stay. The aim of this systematic review was to update the available literature and develop recommendations for optimal pain management after hip fracture. A systematic review utilising procedure specific postoperative pain management (PROSPECT) methodology was undertaken. Randomised controlled trials, systematic reviews and meta-analysis published in the English language between 04 April 2005 and 12 May 2021, evaluating the effects of analgesic, anaesthetic and surgical interventions were retrieved from MEDLINE, Embase and Cochrane Databases. A total of 60 studies met the inclusion criteria. For patients having hip fracture, pre, intra and postoperative paracetamol and non-steroidal anti-inflammatory drugs or COX-2 inhibitors are recommended. A single shot femoral nerve block or a single shot fascia iliaca compartment block are recommended. Continuous catheter techniques should be used only in specific circumstances. The choice between femoral nerve block or a fascia iliaca compartment block should be made according to local expertise. The postoperative regimen should include regular paracetamol, non-steroidal anti-inflammatory drugs and COX-2 inhibitors with opioids used for rescue. Some of the interventions, although effective, carry risks, and consequentially were omitted from the recommendations, while other interventions were not recommended due to insufficient, inconsistent or lack of evidence.

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Efficacy of adding Dexmedetomidine in Fascia Iliaca Compartment Block to provide analgesia for positioning femur fracture patients before spinal anesthesia

Cited by 2 publications

References 19 publications

The efficacy of adding dexmedetomidine perineurally in fascia iliaca compartment block versus intravenously in hip arthroscopy: A randomized controlled trial

The efficacy of adding dexmedetomidine perineurally in fascia iliaca compartment block versus intravenously in hip arthroscopy: A randomized controlled trial

Pain management after hip fracture repair surgery: a systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations

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