Successful Use of Peripheral Nerve Blocks as the Primary Anesthetic in High-Risk Patients Undergoing Hip Surgery: A Case Series

Abstract

The incidence of hip fractures in the United States is increasing as the population ages. Elderly patients are more likely to have extensive comorbidities, which contribute to long-term consequences after a hip fracture. These patients often experience permanent disability, restrictions in activities of daily life, higher rates of depression, cardiovascular disease, and mortality rate. The authors describe a combination of peripheral nerve blocks to provide surgical anesthesia for corrective hip surgery in 5 high-risk patients.

New peripheral nerve blocks and local anesthetics

“…The fascia iliaca compartment is located between the iliac fascia and iliac muscles and involves the femoral, lateral femoral cutaneous, and obturator nerves. As it is distant from the major vascular and nerve structures, the fascia iliaca compartment block has been assumed as an easily applicable block with few complications for femoral fractures and hip surgery in particularly high-risk patients [21]. On the other hand, the conventional fascia iliaca block necessitates a large amount of local anesthetic administered under the inguinal ligament and has uncertain effects.…”