Combined lumbar plexus sciatic nerve block for hip fracture: a case series with 442 patients

Abstract

Introduction: Hip fractures are a global health problem in the elderly population. The mortality and morbidity after anesthesia are high in the elderly population with hip fractures due to numerous comorbidities. In recent years, the combined lumbar sciatic block (CLSB) method is safely applied in high-risk hip fracture surgeries. This study aims to examine 442 cases of hip fracture surgery in our clinic. Method: 442 high-risk patients operated in Istanbul University Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Orthopedics and Traumatology between 2004 and 2016 are included in this retrospective study. Neurostimulation technique combined with lumbar plexus and sciatic nerve block applied in all cases. The Lumber plexus block consists of bupivacaine 15 cc 0.5 % and prilocaine 15 cc 2%. Sciatic nerve block consists of bupivacaine 10 cc 0.5 % and prilocaine 10 cc 2%. Cases are evaluated for anesthesia quality and complication rate. Results: There was no need for any sedation or analgesia in 199 cases. Sedation was required in 147 cases. In 82 cases, the need for sedation combined with analgesia occurred. The conversion to general anesthesia was required in 14 cases. Complication wise, the epidural spread was observed in 5 cases and 3 cases got convulsions. Conclusion: It is concluded that CLSB is a safe alternative technique to use in high-risk hip fracture surgery.