Combined lumbar and sacral plexus block compared with plain bupivacaine spinal anesthesia for hip fractures in the elderly

Efficacy of supplemental peripheral nerve blockade for hip fracture surgery: multiple treatment comparison

“…Overall, 1 (5%) RCT 15 was assessed as low risk of bias, 9 (43%) 14,[16][17][18][19][20][21][22][23] had high risk of bias, and the remaining 11 (52%) 13,[24][25][26][27][28][29][30][31][32][33] The Table lists key characteristics of the eligible studies. They were published from 1991 to 2010 and ranged in size from 14-209 participants.…”

“…We were able to compare acute pain intensity between seven nerve block strategies using data from 16 studies comprising 1,089 subjects. In 15 studies, pain was measured on a 10-cm visual analogue scale or an 11-point numeric rating scale, 13,16,17,[20][21][22][23][24][25]27,28,[30][31][32][33] and in one study, a four-point verbal rating scale was used. 18 Pain was also measured at a variety of intervals (ranging from hourly to daily).…”

“…The criteria used for the diagnosis of delirium were not reported in three studies. 15,19,30 In one study, 16 the Mini Mental State Examination (MMSE) was used, but the change in MMSE necessary to define delirium was not provided. In one other trial, 31 daily MMSE and two other instruments were used to diagnose delirium against the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria.…”

Combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in a patient with severe aortic stenosis

“…3 The sympathetic blockade resulting from the combined block should in theory be less than that seen after a central neuraxial block, making it an attractive alternative for anesthesia in patients with severe aortic stenosis requiring hip surgery. We report the use of a combined paravertebral lumbar plexus and parasacral sciatic nerve block for operative repair of hip fracture in an octogenarian with concomitant severe aortic stenosis, and discuss the choices of technique.…”

Lower limb orthopedic surgery in geriatric patients under paravertebral blocks: A prospective feasibility study

“…In cases of total hip and knee arthoplasties and some other surgeries where post-op pain was expected to be more, 15 a catheter was placed in the lumbar plexus for post-op infusion with 0.1% bupivacain at 6-8 ml/h by a disposable balloon infusion pump after the patient first complained of pain preceding with a bolus of 10 ml of the infusate.…”