Feasibility Of “Hourglass-Pattern” Fascia Iliac Combined With Sacral Plexus Block In Elderly Femoral Neck Fractured Patients Undergoing Closed Reduction And Internal Fixation For Femoral Neck Fractures: A Prospective Observational Study

Abstract

Background: To evaluate the feasibility of "hourglass-sign" fascia iliac block and sacral plexus block for elderly femoral neck fractured patients with multiple complications.Methods: A total of 32 patients with femoral neck fracture undergoing closed reduction and internal fixation for femoral neck fractures were included. Ultrasound-guided "hourglass-sign" fascia iliac block and sacral plexus block anesthesia were applied to all patients. The success rate of anesthesia, the hemodynamic parameters, VAS scores, general clinical data and perioperative information would be collected.Results: 30 patients were included and analyzed into the study finally, all patients were diagnosed with different systemic diseases before surgery. The successful rate of "hourglass-sign" fascia iliac block combined with sacral plexus block guided by ultrasound and nerve stimulator was 93.8%. The change of MAP at different time points was about 5% of the baseline values, and the heart rate was about 7%. VAS scores decreased significantly after anesthesia and continued at least 1 hour after surgery. The anesthesia evaluation degree of most patients was satisfactory. There were no complications or adverse reactions associated with anesthesia. Conclusion:This combined nerve block provided effective anesthesia for closed reduction and internal fixation for femoral neck fractures of elderly patients, rarely caused instability in the circulatory system, had fewer adverse reactions and could be widely used in clinical practice.Trial Registry: This trial was registered at Chinese clinical trial (ChiCTR2000034114)