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PSOAS COMPARTMENT BLOCK FOR HIP REPLACEMENT SURGERY IN ELDERLY HIGH-RISK PATIENTS
Author(s): ,
Sahin, A.S.*
Affiliations:
Kanuni SS Training and Research Hospital, ANESTHESİA AND REANİMATİON, ISTANBUL, Turkey
,
Derbent, A.
Affiliations:
Kanuni SS Training and Research Hospital, ANESTHESİA AND REANİMATİON, ISTANBUL, Turkey
,
Ay, N.
Affiliations:
Kanuni SS Training and Research Hospital, ANESTHESİA AND REANİMATİON, ISTANBUL, Turkey
,
Salihoglu, Z.
Affiliations:
Kanuni SS Training and Research Hospital, ANESTHESİA AND REANİMATİON, ISTANBUL, Turkey
Acikgoz, A.
Affiliations:
Klinikum Nordstat Hannover, Anesthesiology and Reanimation, Hannover, Germany
ESRA Academy. Sahin A. Sep 13, 2017; 190931
Topic: Geriatric Population
Dr. Ayca Sultan Sahin
Dr. Ayca Sultan Sahin

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Abstract
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Background and Aims:

Hip replacement surgery is common among elderly patients. These patients have increased risk of perioperative mortality and morbidity due to additional co-morbidities. The use of regional anaesthetic methods during hip replacement surgery reduces intraoperative blood loss and the risk of postoperative  deep venous thrombosis.

Methods:

Ten patients over age of 70 years, ASA III-IV physical status who underwent elective hip replacement surgery were performed Psoas compartment block. After spinal anesthesia, lateral decubitus position with the side to be operated uppermost and with the hip-knees flexed was provided for each patient. After the L3 spinous process was identified, the transverse process of L3 was located moving the probe horizontally. Then the local anaesthetic was infiltrated into the skin and an insulated stimulation needle connected to a nevre stimulator  was introduced along the long axis of the ultrasound probe. A current strength for nerve stimulator was 0.5-0.8 mA at 1 Hz. The ultrasound guidance needle was slowly advanced under to the posterior part of the psoas muscle and the lumbar plexus was confirmed when ipsilateral quadriceps muscle contraction was observed. 30mL of 0.25%bupivacaine was injected into the psoas compartment. The spread of local anaesthetic in psoas compartment was demonstrated by ultrasound.

Results:

There were no complications in preoperative, peroperative and postoperative period in 10 patients.

Conclusions:

Psoas compartment block produce satisfactory quality of analgesia in elderly high-risk patients with fewer hemodynamic changes. Psoas compartment block is a technique used to provide adequate postoperative analgesia to the ipsilateral lower extremity after operative repair of hip fracture. 

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