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Canadian Journal of Anesthesia

, Volume 49, Issue 9, pp 946–950 | Cite as

Combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in a patient with severe aortic stenosis

  • Anthony M. -H. HoEmail author
  • Manoj K. Karmakar
Regional Anesthesia and Pain

Abstract

Purpose

To report the use of a combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in an elderly patient with severe aortic stenosis.

Clinical features

In an 87-yr-old lady with severe aortic stenosis and fracture of the right trochanter due to a fall, a combined rightsided paravertebral lumbar plexus and parasacral sciatic nerve block was used successfully for operative reduction of the fracture. A moderate amount of phenylephrine was required to maintain adequate systemic blood pressure despite the largely unilateral nature of the blocks.

Conclusion

Combined paravertebral lumbar plexus and parasacral sciatic nerve block can be a viable alternative to general anesthesia and epidural or spinal block for hip surgery in patients with severe aortic stenosis.

Keywords

Bupivacaine Ropivacaine Severe Aortic Stenosis Sciatic Nerve Block Posterior Superior Iliac Spine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Une anesthésie combinée, paravertébrale du plexus lombaire et parasacrée du nerf sciatique, pour la réduction d’une fracture de la hanche chez une patiente souffrant d’une sténose aortique sévère

Résumé

Objectif

Signaler l’usage d’une anesthésie combinée, paravertébrale du plexus lombaire et parasacrée du nerf sciatique, pour la réduction d’une fracture de la hanche chez une patiente âgée qui présentait une sténose aortique sévère.

Éléments cliniques

Une anesthésie combinée, paravertébrale du plexus lombaire et parasacrée du nerf sciatique, du côté droit, a été utilisée avec succès pour la réduction d’une fracture chez une patiente de 87 ans qui présentait une sténose aortique sévère et une fracture du trochanter droit consécutive à une chute. Un quantité modérée de phényléphrine a été nécessaire pour maintenir une tension artérielle adéquate malgré la nature largement unilatérale de l’anesthésie combinée.

Conclusion

L’anesthésie combinée, paravertébrale du plexus lombaire et parasacrée du nerf sciatique, peut remplacer efficacement l’anesthésie générale et l’anesthésie péridurale ou rachidienne pour une intervention à la hanche chez des patients qui présentent une sténose aortique sévère.

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Copyright information

© Canadian Anesthesiologists 2002

Authors and Affiliations

  1. 1.Department of Anaesthesia and Intensive Care, Faculty of MedicineThe Chinese University of Hong Kong, Prince of Wales HospitalHong KongPRC

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