Dexmedetomidine and Bupivacaine Versus Bupivacaine Alone in Ultrasound Guided Fascia Iliaca Compartment Blockade for Femoral Fractures

Background: Pain control is one of the most important issues in femoral fractures. One of the most effective methods is the fascia iliaca compartment block. Objectives: The aim of this study was to compare the efficacy of the addition of dexmedetomidine to bupivacaine on the quality of ultrasound guided blockade of the fascia iliaca compartment in adults undergoing femoral shaft fracture surgery. Methods: This study was a double-blind clinical trial. We studied 60 adults who were hospitalized for a femoral shaft fracture. The patients were divided into two equal groups receiving either bupivacaine alone or bupivacaine and dexmedetomidine for compartment blockade of the iliac fascia. Group allocation was based on the method of randomization from concealed envelopes. Primary outcomes were pain intensity, sedation and analgesic consumption assessed at 1, 2, 6 and 24 hours after surgery in two groups. Data were analyzed using SPSS software. Results: Pain intensity was lower in the dexmedetomidine group 1, 2, 6 and 24 hours after surgery (p<0.05). The sedation score was also higher in the dexmedetomidine group 6 and 24 hours after surgery (p<0.05). The dose of analgesics used by the dexmedetomidine group was significantly lower 6 and 24 h after treatment. No hypotension, respiratory depressionand bradycardia occurred in the patients participating in this study. Conclusion: The addition of dexmedetomidine to bupivacaine during ultrasound-guided blockade of the fascia-iliac compartment is associated with reduced pain intensity and improved sedation in patients undergoing femoral fracture surgery.