Comparison of 4 mg dexamethasone versus 8 mg dexamethasone as an adjuvant to levobupivacaine in fascia iliaca block-a prospective study
10.3344/kjp.2018.31.4.261
- Author:
Ranjita ACHARYA
1
;
Bhavna SRIRAMKA
;
Sandeep PANIGRAHI
Author Information
1. Department of Psychiatry, IMS and SUM Hospital, Bhubaneswar, India.
- Publication Type:Original Article
- Keywords:
Analgesia;
Bupivacaine;
Dexamethasone;
Fascia;
Femoral fractures;
Levobupivacaine;
Local anesthetics;
Pain management;
Spinal anesthesia;
Tramadol
- MeSH:
Analgesia;
Analgesics;
Anesthesia, Spinal;
Anesthetics, Local;
Bupivacaine;
Dexamethasone;
Fascia;
Femoral Fractures;
Humans;
Pain Management;
Prospective Studies;
Tramadol
- From:The Korean Journal of Pain
2018;31(4):261-267
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: To compare the effects of adding two different doses of dexamethasone on the duration and quality of the fascia iliaca block in patients undergoing proximal femoral fracture surgery. METHODS: A total of 60 patients (age 18–70 years) undergoing proximal femoral nailing surgery under spinal anesthesia were given fascia iliaca block after random assignment to one of the two groups: Group H received an injection of levobupivacaine (0.5%) 28 ml with 2 ml (8 mg) dexamethasone, and Group L received an injection of levobupivacaine (0.5%) 28 ml with dexamethasone 1 ml (4 mg) with 1 ml normal saline. Assessment of the duration of analgesia and the total tramadol requirement over 48 hours were noted after a successful block. RESULTS: The duration of analgesia was found to be significantly longer in Group H (17.02 ± 0.45 h) than in the Group L patients (14.29 ± 0.45 h) with a p-value of 0.000. Postoperative analgesic requirement (amount of tramadol in mg) was significantly higher in Group L (Q2: 200.0; IQR: 100.0, 200.0) as compared to Group H (Q2: 100.0; IQR: 100.0, 200.0) with a p-value of 0.034. No patient showed any sign of neurotoxicity. CONCLUSIONS: Dexamethasone, in a dose of 8 mg, is superior to 4 mg when used as an adjuvant with levobupivacaine in the FIB. Though both prolonged analgesia and were effective in reducing oral/intravenous analgesics, 8 mg dexamethasone can be recommended as a more efficacious adjuvant to local anesthetics in the FIB.
