Fascia Iliaca Block Versus Intravenous Dexmedetomidine and Ketamine for Positioning Fracture Femur

Proximal femur fractures are one of the commonest fractures especially in the elderly population. Early surgical fixation is the best analgesic for associated pain. Spinal anesthesia has been favored by many anesthesiologists due to the simplicity of the technique, the better analgesic profile, and the lower incidence of complications like delirium and thromboembolic events. However, severe pain, encountered during positioning for spinal anesthesia, can complicate the technique and worsen the patient experience.the study aim to compare the analgesic effect of intravenous dexmedetomidine and fascia iliaca block preoperatively to assist positioning patients for performance of spinal anesthesia.

Inclusion Criteria:Aged 18-60 years.Hip fracturesBoth sexes.Exclusion Criteria:Patient refusalAllergy to local anestheticsBleeding diathesis or history of anticoagulant use.impaired cognition or dementia. Infection of the skin at the site of needle punctures areamultiple fracturesAny previous analgesic administration during the last 12 hours