Why the study?
Hip fracture surgery in patients with severe aortic stenosis and advanced heart failure presents a major anesthetic challenge due to risks of myocardial depression and hemodynamic instability with general or neuraxial anesthesia.
Comparison
Combined posterior lumbar plexus and subgluteal sciatic nerve blocks without sedation with low-dose norepinephrine infusion
Design
Case report
Key result
Combined posterior lumbar plexus and sciatic nerve blocks allowed successful awake bipolar hemiarthroplasty with preserved hemodynamic stability in a high-risk patient with severe aortic stenosis.
Authors
Loading...
May support regional anesthesia for hemodynamic stability in severe AS; leaves open need for prospective trials before wider use.
Case Report (n=1)
Combined posterior lumbar plexus and sciatic nerve blocks offer a viable anesthetic strategy to maintain hemodynamic stability in patients with severe aortic stenosis and advanced heart failure undergoing urgent hip surgery.
Ali et al. (2026) conducted a case report in Severe low-flow low-gradient aortic stenosis and end-stage ischemic cardiomyopathy requiring hip fracture surgery (n=1). Combined posterior lumbar plexus and subgluteal sciatic nerve blocks was evaluated on Hemodynamic stability and successful completion of surgery. Combined posterior lumbar plexus and sciatic nerve blocks allowed successful awake bipolar hemiarthroplasty with preserved hemodynamic stability in a high-risk patient with severe aortic stenosis.