Shamrock Lumbar Plexus Block for Hip Hemiarthroplasty in a High Risk Elderly Patient with Hip Fracture

J Long Term Eff Med Implants. 2022;32(1):73-76. doi: 10.1615/JLongTermEffMedImplants.2021039397.

Abstract

Hip fractures in the geriatric population are associated with high morbidity and mortality rate. Early surgical fixation is of major importance, as it is one of the factors that contribute to patient optimization. However, these patients usually present a high burden of comorbidities, including aortic stenosis that could affect their treatment. Despite major advances in anesthetic and surgical techniques, severe aortic stenosis remains an independent, important risk factor for patients undergoing anesthesia for noncardiac surgery. In these patients, general and/or neuraxial anesthesia should be avoided; peripheral nerve blockade is a viable option. This article presents a 96-year-old hip fracture patient with severe aortic stenosis and aspiration pneumonia that successfully underwent hip hemiarthroplasty under peripheral nerve blockade as sole anesthesia.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Hemiarthroplasty*
  • Hip Fractures* / surgery
  • Humans
  • Lumbosacral Plexus / surgery
  • Nerve Block* / methods