[Choice of anesthesia in geriatric patients in lower limb surgery]

Three variants of regional anesthesia were used in 162 patients operated on the lower limbs. A combination of the inguinal approach after Winnie for the blocking of the lumbar plexus and sciatic nerve provided a reliable analgesia in operations performed below the middle third of the femur. In interventions on the upper third of the femur and the hip joint segmentary conduction blocking (epidural or spinal anesthesia) should be preferred in geriatric patients, because it is impossible to block the branches of the obturator, sciatic, upper and lower gluteal nerves innervating the hip joint by Winnie's technique, an anatomical obstacle (fascial node) preventing the procedure, as was shown by anatomical experiments with 28 corpses.