Marrone F, Paventi S, Tomei M, Failli S, Crecco S, Pullano C
Unit of Anaesthesia and Intensive Care Santo Spirito Hospital Rome Italy.
Unit of Anaesthesia Villa Pia Clinic Rome Italy.
Anaesth Rep. 2024 Jan 3;12(1):e12269. doi: 10.1002/anr3.12269. eCollection 2024 Jan-Jun.
The provision of anaesthesia for hip fracture surgery in elderly and frail patients can be challenging, with potentially significant risks associated with both general and neuraxial techniques. Here, we report the use of a sacral erector spinae plane block as an alternative to conventional anaesthetic approaches for a frail 89-year-old woman with significant cardiovascular and respiratory comorbidity who underwent intramedullary nailing for a proximal femoral fracture. A unilateral injection of local anaesthetic at the intermediate crest of the second sacral vertebra resulted in bilateral sensory block of the T12 to S2 dermatomes. The technique did not result in hypotension or motor block of the limbs, and the surgery was completed uneventfully. Sacral erector spinae plane block warrants further investigation as an alternative to spinal and general anaesthesia for hip and lower limb surgery.
为老年体弱患者的髋部骨折手术提供麻醉可能具有挑战性，全身麻醉和神经轴索麻醉技术都存在潜在的重大风险。在此，我们报告了对一位患有严重心血管和呼吸系统合并症的89岁体弱女性使用骶棘肌平面阻滞作为传统麻醉方法的替代方案，该患者因股骨近端骨折接受了髓内钉固定术。在第二骶椎中间嵴处单侧注射局部麻醉药导致T12至S2皮节双侧感觉阻滞。该技术未导致低血压或肢体运动阻滞，手术顺利完成。骶棘肌平面阻滞作为髋部和下肢手术脊髓麻醉和全身麻醉的替代方案值得进一步研究。
