PDF(Pubmed)
Abstract：
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.
摘要：
为老年和体弱患者的髋部骨折手术提供麻醉可能具有挑战性，与一般和神经轴技术相关的潜在重大风险。这里,我们报道了使用骶骨竖脊肌平面阻滞作为常规麻醉方法的替代方法,该方法适用于患有严重心血管和呼吸道合并症的89岁虚弱女性,该女性因股骨近端骨折接受了髓内钉治疗.在第二骶椎的中间峰单侧注射局部麻醉剂会导致T12至S2皮囊的双侧感觉阻滞。该技术没有导致四肢低血压或运动阻滞，手术顺利完成。骶骨竖脊肌平面阻滞值得进一步研究，以替代髋关节和下肢手术的脊柱和全身麻醉。
