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


METHODS
In an 87-yr-old lady with severe aortic stenosis and fracture of the right trochanter due to a fall, a combined right-sided 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.


CONCLUSIONS
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.
Ho
Anthony M H
AM
Department of Anaesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, PRC.
Karmakar
Manoj K
MK
D000368:Aged; D000369:Aged, 80 and over; D000775:Anesthesia, Spinal; D018686:Anesthetics, Intravenous; D001024:Aortic Valve Stenosis / Q000150:complications* / Q000503:physiopathology; D003704:Dementia / Q000150:complications / Q000523:psychology; D005260:Female; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D008160:Lumbosacral Plexus; D009407:Nerve Block; D019637:Orthopedic Procedures; D015742:Propofol; D012584:Sciatic Nerve
D018686:Anesthetics, Intravenous; D015742:Propofol