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.