Key result
Lumbar plexus block in elderly patients undergoing hip fracture surgery resulted in a 0% failure rate and no complications, maintaining hemodynamic stability and high surgeon satisfaction.
Observational (n=50)
No
Lumbar plexus block combined with light sedation is a safe and effective anesthetic option that preserves hemodynamic stability in elderly patients undergoing hip fracture surgery.
May support lumbar plexus block as a stable option in select elderly hip fracture cases; hypothesis-generating, requires randomized confirmation.
BACKGROUND: Lumbar plexus block (LPB) is one of the anesthetic options in the elderly patients undergoing hip surgeries. LPB could be safe because it targets somatic nerve in psoas region. Effectiveness of LPB is attributed to the sufficient analgesia provided intraoperatively as well as postoperatively. Adequate muscle relaxation and immobility during surgery refers to its acceptability. OBJECTIVES: In this study, LPB was used as the anesthetic method to manage the elderly patients subjected to hip surgery. PATIENTS AND METHODS: A total of 50 patients aged 51 to 100 years were enrolled in this study. LPB was accomplished after a mild sedation and with a modified method using patient's fingertip width (FTW) as the distance unit to determine needle entry point under electrical nerve stimulation assistance. After targeted injection, procedure time, establishment time, block duration, surgery time, hemodynamic variables, and surgeon satisfaction score were documented and analyzed. Propofol in trivial doses was infused intraoperatively to provide clinical sedation. RESULTS: Mean patient's age was 73 ± 12 years with ASA II/III. Procedure time was 5.65 ± 1.24 minutes, establishment time was 130 ± 36 seconds, block duration was 13.1 ± 8 hours, surgery time was 149.7 ± 32.2 minutes, and surgeon satisfaction score was 9.8 ± 0.1. There was no complication and no failure. Hemodynamic stability was pleasantly achieved. CONCLUSIONS: By preserving hemodynamic stability, LPB in conjunction with a light sedation could be considered as a reliable prudent satisfying anesthetic option in management of hip fractures in the elderly patients with three beneficial characteristics of safety, effectiveness, and acceptability.
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Amiri et al. (2014) conducted an observational in Hip fractures (n=50). Lumbar plexus block was evaluated on Block failure and complications. Lumbar plexus block in elderly patients undergoing hip fracture surgery resulted in a 0% failure rate and no complications, maintaining hemodynamic stability and high surgeon satisfaction.
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