Comparing Two Different Doses of Clonidine as an Adjuvant to Bupivacaine in Blind Fascia Iliaca Compartment Block Preoperatively in Patients Posted for Femur Fractures
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 2
Abstract
Background: Femur fractures occur commonly due to trauma and cause excruciating pain causing difficulty in the positioning of a patient during spinal anesthesia. Fascia iliaca compartment block is an easy, bedside procedure for pain relief of such a patient. Addition of clonidine to local anesthetic agent improves the quality of analgesia. Aims: The aim of the study was to study the effect of two different doses, 50 μg and 100 μg of clonidine as an adjuvant to bupivacaine in blind fascia iliaca compartment block orthopedic patients with a femur fracture. Methods: A total of 120 adult patients of either sex, belonging to American Society of Anesthesiologists (ASA) physical status Class I and II, admitted in an orthopedic ward with femur fractures were randomly divided into three groups. The patients in Group I (control) received 39ml of 0.25% bupivacaine + 1 ml of normal saline, in Group II received 39 ml of 0.25% bupivacaine + 50 μg of clonidine diluted to 1 ml, and in Group III received 39 ml of 0.25% bupivacaine + 100 μg clonidine diluted to 1 ml. The demographic characteristics, hemodynamic parameters, ASA physical status, visual analog scale (VAS) scores, onset of analgesia, duration of analgesia, number of rescue analgesics, and any side effects and patient satisfaction during positioning for spinal anesthesia were noted. Results: VAS scores till 24 h were lower in clonidine groups. The onset of analgesia was also reduced in clonidine groups. The mean duration of analgesia in Group I was 5.4 ± 0.6 h, 11.5 ± 0.3 h in Group II, and 16 ± 0.4 in Group III. The total number of rescue analgesics consumed in Group I was 4.5 ± 0.5, 3.2 ± 0.8 in Group II, and 2.8 ± 0.7 in Group III. The patient satisfaction during positioning for spinal anesthesia after the fascia iliaca compartment block was satisfactory in 30 patients in Group I, 34 patients in Group II, and 35 patients in Group III. Conclusions: We conclude that the use of 50 μg clonidine as an adjuvant to bupivacaine in fascia iliaca compartment block for femoral fracture patients as a component to multimodal analgesic approach for effective pain relief.
Authors and Affiliations
Meena Singh, Vandana Pandey, Mamta Mahobia
Keywords
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