Ho Anthony M H, Karmakar Manoj K
Department of Anaesthesia and Intensive Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, PRC.
Can J Anaesth. 2002 Nov;49(9):946-50. doi: 10.1007/BF03016880.
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.
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.
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.
报告在一名患有严重主动脉瓣狭窄的老年患者中，使用椎旁腰丛联合骶旁坐骨神经阻滞来减少髋部骨折。
一名87岁女性，因跌倒导致严重主动脉瓣狭窄及右侧转子骨折，成功使用右侧椎旁腰丛联合骶旁坐骨神经阻滞进行骨折手术复位。尽管阻滞主要为单侧性，但仍需要适量的去氧肾上腺素来维持足够的全身血压。
对于患有严重主动脉瓣狭窄的患者，椎旁腰丛联合骶旁坐骨神经阻滞可作为髋部手术全身麻醉、硬膜外或脊髓阻滞的可行替代方法。
