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Combined Lumbar-Sacral Plexus Block in High Surgical Risk Geriatric Patients undergoing Early Hip Fracture Surgery
S Petchara1, S Paphon2, A Vanlapa1
1Department of Anesthesiology, Ramathibodi Hospital, Bangkok, Thailand.
Objective:
To evaluate the postoperative outcome after using combined lumbar and sacral plexus block (CLSB), as a sole anesthetic method in hip fracture (HF) surgery in highrisk geriatric patients.
Materials And Methods:
A single-center retrospective study was conducted, between 2010 and 2012, on 70 elderly HF patients with American Society of Anesthesiologists grading III-IV who underwent early surgical intervention with our CLSB protocol. Perioperative data, outcome, and complications were recorded.
Results:
Forty-eight patients (69%) had ongoing anticoagulant medication. Postoperatively, all patients were hemodynamically stable and awake. None of them required general anesthesia conversion. Minor anesthetic-related complications were found in nine patients. One patient (1%) died from sepsis due to pneumonia. Patients' satisfactions were all rated as very good or excellent.
Conclusion:
CLSB is an interesting anesthetic option in HF surgery, especially in high surgical risk geriatric patients. This method offers an excellent clinical efficiency and high patients' satisfaction without serious complications.
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