Comparison of intravenous dexmedetomidine and ketamine with femoral nerve block for positional pain before spinal anaesthesia in patients with fracture femur: A prospective randomised study.

Introduction: Patient positioning for spinal anaesthesia in patients with femur fracture is extremely painful and various methods have been tried to reduce mobilisation pain.

Aim: To compare the analgesic efficacy of intravenous dexmedetomidine, ketamine and femoral nerve block in patients posted for fractured femur for alleviating the positional pain before spinal anaesthesia.

Materials and methods: A total of 75 patients (25 per group) of American Society of Anaesthetists Grade I-III patients of age group 18-80 years with fractured femur scheduled for elective surgery. All patients in Group C (n = 25) were given the femoral nerve block, Group D (n = 25) were given intravenous dexmedetomidine 0.5µg/kg and Group K (n = 25) were given intravenous ketamine 0.3mg/kg. The parameters assessed were quantitative relief of pain by a numerical rating scale and patient satisfaction score, quality of patient positioning and time to perform spinal anaesthesia along with hemodynamics and sedation score.

Results: The pain scores and patient satisfaction scores were significantly decreased in all three groups but were much significantly lower in Group K.

Conclusion: Ketamine was found to be superior to the other two groups in terms of reducing positional pain.