Combined Lumbar-Sacral Plexus Block in High Surgical Risk Geriatric Patients undergoing Early Hip Fracture Surgery

S Petchara, S Paphon, A Vanlapa, P Boontikar, K Disya, S Petchara, S Paphon, A Vanlapa, P Boontikar, K Disya

Abstract

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.

Keywords: CLSB protocol; Sole anaesthetic; combined lumbar and sacral plexus block; hip fracture surgery; peripheral nerve blockade.

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