Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study
Background and Aims: The fragile elderly population suffering from hip fractures presents an anaesthetic challenge; therefore, widening the armamentarium for surgical treatment should be sought. This retrospective study presents a new primary anaesthetic method for intramedullary femoral nailing (IM...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
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| Series: | Indian Journal of Anaesthesia |
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| Online Access: | https://journals.lww.com/10.4103/ija.ija_695_24 |
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| author | Carlos Rodrigues Almeida |
| author_facet | Carlos Rodrigues Almeida |
| author_sort | Carlos Rodrigues Almeida |
| collection | DOAJ |
| description | Background and Aims:
The fragile elderly population suffering from hip fractures presents an anaesthetic challenge; therefore, widening the armamentarium for surgical treatment should be sought. This retrospective study presents a new primary anaesthetic method for intramedullary femoral nailing (IMFN) surgery in the context of hip fracture: the sequential proximal iliopsoas compartment (SPIC) block.
Methods:
This single-centre retrospective study involved 25 patients aged 80 or older submitted to IMFN surgery. The patients were given a single-shot SPIC block using a total of 25 ml of ropivacaine 0.5% plus dexamethasone 8 mg administered sequentially in the proximal iliopsoas space, divided equally as per two different sites as a primary anaesthetic technique associated with moderate sedation. The outcome measure was the adequacy of the anaesthetic approach. The one-tailed Wilcoxon signed-rank test compared the preoperative numerical pain rating scale (NPRS) with the NPRS at 24 h and the pre-incision with the maximum intraoperative mean arterial pressure.
Results:
The patients were successfully anaesthetised, had no vasopressor consumption, had good surgical conditions, and had no complaints recorded. No tachycardia or hypertensive events were noted. No additional opioids were given. No statistically different values were observed when the pre-incisional and intraoperative mean arterial pressure values were compared (P = 0.52), and the preoperative NPRS compared with the NPRS at 24 h showed a statistically significant difference (P < 0.001).
Conclusion:
The SPIC block combined only with moderate sedation permits adequate anaesthesia while avoiding the significant risk of neuraxial/sympathetic blockade. |
| format | Article |
| id | doaj-art-a2b822908abc4041b4c78ca8efd5071b |
| institution | Kabale University |
| issn | 0019-5049 0976-2817 |
| language | English |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Indian Journal of Anaesthesia |
| spelling | doaj-art-a2b822908abc4041b4c78ca8efd5071b2025-02-06T09:46:41ZengWolters Kluwer Medknow PublicationsIndian Journal of Anaesthesia0019-50490976-281769222022410.4103/ija.ija_695_24Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective studyCarlos Rodrigues AlmeidaBackground and Aims: The fragile elderly population suffering from hip fractures presents an anaesthetic challenge; therefore, widening the armamentarium for surgical treatment should be sought. This retrospective study presents a new primary anaesthetic method for intramedullary femoral nailing (IMFN) surgery in the context of hip fracture: the sequential proximal iliopsoas compartment (SPIC) block. Methods: This single-centre retrospective study involved 25 patients aged 80 or older submitted to IMFN surgery. The patients were given a single-shot SPIC block using a total of 25 ml of ropivacaine 0.5% plus dexamethasone 8 mg administered sequentially in the proximal iliopsoas space, divided equally as per two different sites as a primary anaesthetic technique associated with moderate sedation. The outcome measure was the adequacy of the anaesthetic approach. The one-tailed Wilcoxon signed-rank test compared the preoperative numerical pain rating scale (NPRS) with the NPRS at 24 h and the pre-incision with the maximum intraoperative mean arterial pressure. Results: The patients were successfully anaesthetised, had no vasopressor consumption, had good surgical conditions, and had no complaints recorded. No tachycardia or hypertensive events were noted. No additional opioids were given. No statistically different values were observed when the pre-incisional and intraoperative mean arterial pressure values were compared (P = 0.52), and the preoperative NPRS compared with the NPRS at 24 h showed a statistically significant difference (P < 0.001). Conclusion: The SPIC block combined only with moderate sedation permits adequate anaesthesia while avoiding the significant risk of neuraxial/sympathetic blockade.https://journals.lww.com/10.4103/ija.ija_695_24analgesiafour-in-one blockhip fracturesorthopaedicsregional anaesthesiasequential proximal iliopsoas compartment block |
| spellingShingle | Carlos Rodrigues Almeida Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study Indian Journal of Anaesthesia analgesia four-in-one block hip fractures orthopaedics regional anaesthesia sequential proximal iliopsoas compartment block |
| title | Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study |
| title_full | Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study |
| title_fullStr | Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study |
| title_full_unstemmed | Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study |
| title_short | Novel sequential proximal iliopsoas compartment block: A four-in-one block as a primary anaesthetic technique for intramedullary femoral nailing surgery: A retrospective study |
| title_sort | novel sequential proximal iliopsoas compartment block a four in one block as a primary anaesthetic technique for intramedullary femoral nailing surgery a retrospective study |
| topic | analgesia four-in-one block hip fractures orthopaedics regional anaesthesia sequential proximal iliopsoas compartment block |
| url | https://journals.lww.com/10.4103/ija.ija_695_24 |
| work_keys_str_mv | AT carlosrodriguesalmeida novelsequentialproximaliliopsoascompartmentblockafourinoneblockasaprimaryanaesthetictechniqueforintramedullaryfemoralnailingsurgeryaretrospectivestudy |