Dexamethasone as An Adjuvant to Fascia Iliaca Compartment Block for Surgeries of Hip Fracture: A Systematic Review .

There is limited evidence for adding dexamethasone to fascia iliaca compartment block (FICB) in hip-fracture surgery; only four small RCTs exist, and they’re too heterogeneous for a pooled analysis. Across studies, dexamethasone consistently improved analgesia-related outcomes: patients needed fewer rescue medications, went longer before requesting them, and experienced longer block duration. Safety signals were reassuring, with no increase in adverse events. But when it comes to pain scores themselves, results were mixed—two trials showed no meaningful difference compared with FICB alone. Overall, the early data look promising for enhanced analgesia, but the evidence base is thin, methods are inconsistent, and stronger, well-designed RCTs are needed before making firm clinical recommendations.