Tulgar Serkan, Ermis Mehmet Nurullah, Ozer Zeliha
Department of Anesthesiology and Reanimation, Maltepe University Faculty of Medicine, Istanbul, Turkey.
Department of Orthopedics and Traumatology, Maltepe University Faculty of Medicine, Istanbul, Turkey.
Indian J Anaesth. 2018 Oct;62(10):802-805. doi: 10.4103/ija.IJA_230_18.
Femur neck fractures may occur in elderly patients with multiple co-morbidities. Spinal or general anaesthesia may not be safe in such patients, leading to a search for other safer alternatives. Herein, we report a case in which a never previously reported combination of quadratus lumborum block (QLB) and erector spinae plane block (ESPB) was successfully used as the main anaesthetic method for hemiarthroplasty. An 86-year-old female patient with severe aortic stenosis was scheduled for internal fixation or hemiarthroplasty due to right femoral neck fracture. Following sedoanalgesia, the patient was placed in lateral decubitis position and ESPB and transmuscular QLB were performed from the fourth lumbar vertebra level. Adequate and effective surgical anaesthesia was achieved and hemiarthroplasty was performed. The combination of lumbar ESPB and QLB can be used for the anaesthesia management in high-risk patients undergoing hemiarthroplasty.
股骨颈骨折可能发生在患有多种合并症的老年患者中。对于这类患者，脊髓麻醉或全身麻醉可能不安全，因此需要寻找其他更安全的替代方法。在此，我们报告一例病例，其中一种此前从未报道过的腰方肌阻滞（QLB）和竖脊肌平面阻滞（ESPB）的联合方法成功用作半髋关节置换术的主要麻醉方法。一名86岁患有严重主动脉瓣狭窄的女性患者因右股骨颈骨折计划进行内固定或半髋关节置换术。在进行镇静镇痛后，患者被置于侧卧位，从第四腰椎水平进行ESPB和经肌QLB。实现了充分有效的手术麻醉并进行了半髋关节置换术。腰段ESPB和QLB的联合可用于接受半髋关节置换术的高危患者的麻醉管理。
