Abstract

SPINAL ANASTHESIA AND FEMORAL FRACTURE, POSITIONING, ANALGESIA DEXMEDETOMIDINE-KETAMINE VERSUS DEXMEDETOMIDINE-FENTANYL

Dr. Duraid Husam Mohammad Saeed*

ABSTRACT

Changes in position necessary for spinal stabilization will cause the most discomfort for people who have femoral fractures, experts predict. anesthesia. We studied the analgesic effects of intravenous dexmedetomidine-ketamine and morphine on pain alleviation. Anesthesia for older people with proximal spines can be made easier with dexmedetomidine-fentanyl combinations. fractures of the femur Patients were divided into two groups at random and given either ketamine or a placebo intravenously. A 10 minute loading dose of dexmedetomidine and 1 mg/kg of fentanyl (group DK) or 1 mg/kg of fentanyl intravenously (group D F) were administered simultaneously. after 20 minutes of continuous 0.6mg/kg/h dexmedetomidine infusion, it was titrated at a rate of 0.02 to 0.06mg/kg/h. The duration of the procedure. The infusion of ketamine or fentanyl was completed by placing the patients in the lateral posture. in order to raise the fracture site It's a pain score of 0 (calm), 1 (facial grimace), 2 (moaning), 3 (screaming), and 4 (unable to proceed) if you're in pain. discomfort was described as "agitated or restless" throughout each step of the procedure (e.g., lateral positioning, hip positioning) flexion and lumbar puncture) and a quality score (0 indicates poor hip flexion, 1 indicates satisfactory hip flexion, 2 indicates adequate hip flexion, and 3 indicates ideal hip flexion) The quality of posture was described using the term hip flexion. In the lateral region, participants in Group DK reported median pain scores of 0 (0-1), 0 (0–0), and 0 (0–0) GroupDF scored 3 (2.75–3), 3 (2–3), and 0 (0–1), respectively, for placement, hip flexion, and lumbar puncture. respectively. GroupD K had considerably lower pain scores in lateral positioning (P.0001) and hip flexion (P.0001) than group Spinal anesthetic placement quality scores were substantially higher in group DK than in group DF (P =.0044). There were no significant differences in side effects including bradycardia, hypotension, or desaturation between the two groups. The Compared to placebo, dexmedetomidine-ketamine treatment reduced pain intensity and improved quality of life for patients with chronic low back pain. placement of elderly patients with proximal femoral fractures during spinal anesthesia without significant deleterious consequences.

Keywords: Analgesia, dexmedetomidine, fentanyl, ketamine, and spinal anesthesia.