Combined Lumbar-Sacral Plexus Block in High Surgical Risk Geriatric Patients undergoing Early Hip Fracture Surgery

• Main Authors: Petchara S, Paphon S, Vanlapa A, Boontikar P, Disya K
• Format: Article
• Language: English
• Published: Malaysian Orthopaedic Association 2015-11-01
• Series: Malaysian Orthopaedic Journal
• Subjects: Sole anaesthetic; combined lumbar and sacral plexus block; CLSB protocol; hip fracture surgery; peripheral nerve blockade
• Online Access: http://www.morthoj.org/2015/v9n3/combined-lumbar-sacral-plexus.pdf

Objective: To evaluate the postoperative outcome after using combined lumbar and sacral plexus block (CLSB), as a sole anesthetic method in hip fracture (HF) surgery in highrisk geriatric patients. Materials and Methods: A single-center retrospective study was conducted, between 2010 and 2012, on 70 elderly HF patients with American Society of Anesthesiologists grading III-IV who underwent early surgical intervention with our CLSB protocol. Perioperative data, outcome, and complications were recorded. Results: Forty-eight patients (69%) had ongoing anticoagulant medication. Postoperatively, all patients were hemodynamically stable and awake. None of them required general anesthesia conversion. Minor anesthetic-related complications were found in nine patients. One patient (1%) died from sepsis due to pneumonia. Patients’ satisfactions were all rated as very good or excellent. Conclusion: CLSB is an interesting anesthetic option in HF surgery, especially in high surgical risk geriatric patients. This method offers an excellent clinical efficiency and high patients’ satisfaction without serious complications.