European Journal of Cardiovascular Medicine

Background: Proximal femur fractures are associated with significant perioperative pain, warranting effective analgesic strategies. This study aimed to systematically compare the analgesic efficacy of Bupivacaine with Dexamethasone versus Bupivacaine alone in Fascia Iliaca Compartment Block (FICB) for patients undergoing proximal femur fracture surgery.

Objective: We conducted a prospective, double-blind, randomized controlled trial to assess the impact of Dexamethasone supplementation on various analgesic outcomes, including time to first rescue analgesia, total rescue analgesia requirements, adverse effects, and Visual Analog Scale (VAS) scores for pain intensity.

Methods: Adult patients were randomly assigned to Group 1 (Bupivacaine with Dexamethasone) or Group 2 (Bupivacaine alone) for FICB. The primary aim was to evaluate the time to first rescue analgesia, with secondary outcomes including total rescue analgesia requirements, adverse effects, and VAS scores. Demographic and clinical profiles were also assessed.

Results: Group 1 exhibited a significantly prolonged time to first rescue analgesia (p < 0.0001), reduced total rescue analgesia requirements (p = 0.019), and a lower incidence of adverse effects (p not significant) compared to Group 2. VAS scores for pain intensity consistently favored Group 1 at all postoperative time points (p < 0.0001). Demographic profiles were comparable, except for significant differences in height and weight.

Conclusion: Our findings underscore the enhanced analgesic efficacy of Bupivacaine with Dexamethasone in FICB for proximal femur fracture surgery. Dexamethasone supplementation demonstrated a prolonged analgesic effect, reduced rescue analgesia requirements, and an improved safety profile compared to Bupivacaine alone. These results provide valuable insights for optimizing perioperative pain management in this vulnerable patient population, emphasizing the potential role of Dexmedetomidine as an adjunct in regional anesthesia.