title: [Ultrasound-guided combined femoral nerve and lateral femoral cutaneous nerve blocks for femur neck fracture surgery--case report].
abstract: We report two cases of elderly patients who underwent ultrasound-guided combined femoral nerve and lateral femoral cutaneous nerve blocks for osteosynthesis of femur neck fracture. In both cases, neuraxial anesthesia was contraindicated due to coagulopathy, and severe restrictive ventilatory disorder was observed. The femoral nerve and lateral femoral cutaneous nerve blocks were performed with 20ml of 0.375% ropivacaine under ultrasonographic visualization using a high frequency linear probe. Ultrasonographic visualization was useful to identify the needle tip and to observe the spread of local anesthetics. Supplemental local infiltration of anesthetics and intravenous low-dose sedative drugs were administered during surgery. The perioperative course was uneventful in both cases. This combined block technique could be a choice for osteosynthesis of femur neck fracture especially in high-risk patients.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Jichi Medical University, Shimotsuke 329-0498.
authors.forename: Kunihisa
authors.initials: K
authors.lastname: Hotta
authors.forename: Naho
authors.initials: N
authors.lastname: Sata
authors.forename: Hideo
authors.initials: H
authors.lastname: Suzuki
authors.forename: Mamoru
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Norimasa
authors.initials: N
authors.lastname: Seo
mesh_terms: D000368:Aged; D000577:Amides / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D005260:Female; D005265:Femoral Neck Fractures / Q000601:surgery*; D005267:Femoral Nerve; D005593:Fracture Fixation, Internal; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D009407:Nerve Block / Q000379:methods*; D019990:Perioperative Care; D012306:Risk; D000077212:Ropivacaine; D012867:Skin / Q000294:innervation*; D014463:Ultrasonography
chemical_list: D000577:Amides; D000779:Anesthetics, Local; D006993:Hypnotics and Sedatives; D000077212:Ropivacaine