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

Abstract

P Pu ur rp po os se e: : To report the use of a combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in an elderly patient with severe aortic stenosis.

Combination of high-dose dexmedetomidine sedation and fascia iliaca compartment block for hip fracture surgery

“…Anesthetic techniques involving mainly peripheral nerve blocks also have been reported [5][6][7][8].…”

Lower-extremity peripheral nerve blockade: Essentials of our current understanding

“…In combination with parasacral nerve block, it has been used for hip fracture repair. 16 It is successfully used for analgesia after total hip arthroplasty (THA) or total knee arthroplasty (TKA). 2,4,17,18 It has also been used in the treatment of chronic hip pain.…”

Is neuraxial blockade contraindicated in the patient with aortic stenosis?

“…In general, peripheral nerve block offers more hemodynamic stability than a neuraxial block, but again with the caveat that stability is not guaranteed. In a report by Ho et al, 14 moderate doses of vasoconstrictive drug were required to maintain normal blood pressure in their elderly patient with severe AS. Lumbosacral plexus block combinations have a 10% risk of epidural spread, creating a contralateral block with associated sympathectomy.…”