Comparison of Clonidine&Dexamethasone as Additive to Bupivacaine in Fascia Iliaca Compartment Block for Postoperative Analgesia in Patients Undergoing Lower Limb Orthopedic Surgeries

Introduction: The use of FICB is safe and effective approach to postoperative analgesia. Major lower limb surgery often painful& require aggressive postoperative pain management. Poorly treated patient can have negative impact on recovery. Aims& Objective: To compare postoperative analgesia in both the group using VAS score -To compare the consumption of rescue analgesics -To observe any complication in both the group Method Study Setting: Jhalawar medical college& hospital jhalawar. Study Design: Prospective randomized single blinded study Sample Size: 80 patients, age 18 to 65 years Sampling Technique: Computer generated random numbers. Study Group: 40 in each group Group 1: FICB with 48 ml 0.25 % bupivacaine + 50mcg clonidine diluted with NS upto 2ml Group 2: FICB with 48 ml 0.25 % bupivacaine + 8mg dexametahsone (2ml). Observation& Result: At 12 hours after surgery: Mean VAS score at rest was 3.41.4 in group1 and 2.461.9 in group2 (P value=0.006) -Mean VAS score during movement was 4.840.99 in group1 and 4.221.49 in group2 (P value=0.015) -There score at rest and during movement There was no significant difference was found in both group in terms of VAS score after 24 hours postoperatively both sat rest and during movement. Mean requirement of number of rescue analgesic was 1.960.66 in group1 and 1.600.75 in group2, which was statistically significant ( P value =0.018). Conclusion: Our study show that adding dexamethasone to bupivacaine for FICB has better analgesia in early postoperative period and decreased requirement of rescue analgesic as compared to patient who received clonidine as additive to bupivacaine. We conclude that dexamethasone provide better analgesic effect than clonidine. However larger prospective randomized trials are required to establish the superior efficacy of dexamethasone.