Is lumbosacral plexus block an effective and safe alternative as surgical anesthesia for total hip replacement?

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BACKGROUND An increasing number of patients for total hip replacement presents with cardiovascular comorbidities, that render them fragile to traditional methods of anesthesia. The aim of this intended study is to compare lumbosacral plexus blockade with continuous spinal anesthesia for surgical anesthesia in total hip replacement. We hypothesize that lumbosacral plexus blockade induces less hemodynamic impact compared to continuous spinal anesthesia.
METHODS Thirty patients (ASA I-III, age ≥ 50 years) will be included for elective hip replacement after informed consent. Hemodynamics will be monitored using calibrated pulse contour analyses of the femoral artery pressure. All patients will receive a lumbar spinal catheter as well as lumbosacral plexus blockade. Group 1: Ropivacaine for the plexus blockade and placebo for the spinal catheter. Group 2: Bupivacaine for the spinal catheter and placebo for the plexus blockade. Patients, anesthesiologist and observer will be blinded for the intervention. Hemodynamic parameters will be recorded during a 1-hour-period following the interventions.
RESULTS The primary endpoint will be the change in cardiac output from baseline to 30 minutes after the interventions. Secondary endpoints will include change in systemic vascular resistance, mean arterial pressure, central venous pressure and central venous oxygen saturation.
CONCLUSIONS We expect that our findings will support the hypothesis of a reduced hemodynamic impact from lumbosacral plexus blockade compared to continuous spinal anesthesia. This might favor the future use of lumbosacral plexus blockade for patients with severe cardiovascular comorbidities.
Original languageDanish
Publication year27 Jan 2017
Publication statusPublished - 27 Jan 2017
EventPhD Day 2017: Science - keep it simple - Aarhus Universitet, Aarhus, Denmark
Duration: 27 Jan 201727 Jan 2017
http://phd.au.dk/gradschools/health/phdday/

Conference

ConferencePhD Day 2017
LocationAarhus Universitet
CountryDenmark
CityAarhus
Period27/01/201727/01/2017
Internet address

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