Role of clonidine in fascia iliaca compartment block for preoperative analgesia in post hip fracture patients: A comparative study

Abstract

Background: Fractures around the hip joint are associated with considerable moderate to severe pain. Adequate preoperative analgesia in these patients is difficult to assess and often an overseen aspect of their care. This study was aimed to assess the efficacy of adding clonidine as adjuvant in fascia iliaca compartment block (FICB) in relieving pain and increasing the pain free duration in the preoperative period. Methods: Sixty patients were divided into three groups of 20 each. Patients in group A received 40 ml of 0.25% bupivacaine + 100μg clonidine and patients in group B received 40 ml of 0.25% bupivacaine + 50μg clonidine whereas group C (the control group) patients were given only 40 ml of 0.25% bupivacaine. Changes in heart rate and blood pressure were recorded in each group. Results: There was significant improvement in VAS and Sitting Score in both the groups after the block and the findings of paired t test on VAS at 1Hr, 2Hr, 6Hr was comparable (P>0.05) but showed significant difference the next morning (P<0.05). The patients of group A had a total pain free sleep of more than 12 hrs after the block. Conclusion: The results suggest that 100μg clonidine is superior to 50μg clonidine and the control group and is the appropriate dose in fascia iliaca compartment block and provides significant benefit in terms of pain relief at rest as well as during transportation and more importantly also facilitates positioning required for proper imaging in the preoperative period. © 2011 Tomar GS.