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A Problem-Based Approach to Hip Fracture Surgery in Frail Patients: Combining Sacral ESP and Quadro-iliac Plane
Francesco Marrone1, Tommaso Sorrentino2, Pierfrancesco Fusco3
1From the Department of Anesthesia and Intensive Care, Santo Spirito Hospital, Rome, Italy.
Abstract:
Hip fractures in elderly patients are associated with morbidity and mortality, and anesthetic management may be challenging when comorbidities or ongoing antiplatelet/anticoagulant therapy limit the use of general or neuraxial anesthesia. We report two cases of hip fracture fixation performed using a combination of sacral erector spinae plane (ESP) block and Quadro-Iliac Plane (QIP) block under dexmedetomidine sedation with spontaneous ventilation. Both patients reported minimal to no pain for several hours after surgery and only requested and received paracetamol at 12 and 18 hours after surgery.
