title: Lumbar plexus block for management of hip surgeries.
abstract: BACKGROUND
  Lumbar plexus block (LPB) is one of the anesthetic options in the elderly patients undergoing hip surgeries. LPB could be safe because it targets somatic nerve in psoas region. Effectiveness of LPB is attributed to the sufficient analgesia provided intraoperatively as well as postoperatively. Adequate muscle relaxation and immobility during surgery refers to its acceptability.
  
  
  OBJECTIVE
  In this study, LPB was used as the anesthetic method to manage the elderly patients subjected to hip surgery.
  
  
  METHODS
  A total of 50 patients aged 51 to 100 years were enrolled in this study. LPB was accomplished after a mild sedation and with a modified method using patient's fingertip width (FTW) as the distance unit to determine needle entry point under electrical nerve stimulation assistance. After targeted injection, procedure time, establishment time, block duration, surgery time, hemodynamic variables, and surgeon satisfaction score were documented and analyzed. Propofol in trivial doses was infused intraoperatively to provide clinical sedation.
  
  
  RESULTS
  Mean patient's age was 73 ± 12 years with ASA II/III. Procedure time was 5.65 ± 1.24 minutes, establishment time was 130 ± 36 seconds, block duration was 13.1 ± 8 hours, surgery time was 149.7 ± 32.2 minutes, and surgeon satisfaction score was 9.8 ± 0.1. There was no complication and no failure. Hemodynamic stability was pleasantly achieved.
  
  
  CONCLUSIONS
  By preserving hemodynamic stability, LPB in conjunction with a light sedation could be considered as a reliable prudent satisfying anesthetic option in management of hip fractures in the elderly patients with three beneficial characteristics of safety, effectiveness, and acceptability.
authors.affiliation: Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Hamid Reza
authors.initials: HR
authors.lastname: Amiri
authors.affiliation: Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran ; Department of Anesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammad Mahdi
authors.initials: MM
authors.lastname: Zamani
authors.affiliation: Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran ; Department of Anesthesiology, Rasoul-Akram Medical Center, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Safari
keywords: Anesthesia, Regional; Arthroplasty; Hip Fractures; Lumbosacral Plexus; Nerve Block