TY - ABST

T1 - Is lumbosacral plexus blockade effective and safe for surgical anesthesia in total hip replacement?

T2 - The 36th Annual ESRA Congress

AU - Nielsen, Niels Dalsgaard

AU - Larsen, Jens Rolighed

AU - Børglum, Jens

AU - Petersen, Jens Aage Kølsen

AU - Runge, Charlotte

AU - Søballe, Kjeld

AU - Bendtsen, Thomas Fichtner

N1 - Conference code: 36

PY - 2017/9/13

Y1 - 2017/9/13

N2 - Background and Aims Patients scheduled for total hip replacement often presents cardiovascular comorbidity, which increases perioperative risk of complications. This pilot study aimed to compare lumbosacral plexus blockade with continuous and single-dose spinal anesthesia for surgical anesthesia in total hip replacement. We hypothesized that lumbosacral plexus blockade induced the least hemodynamic impact.Methods Eight patients for elective hip replacement were included following informed consent. Hemodynamic impact was assessed using pulse contour analyses of the femoral artery pressure. Group 1 had lumbosacral plexus blockade (lumbar plexus block, sacral plexus block and fascia transversalis plane block) with ropivacaine. Group 2 had continuous spinal anesthesia with repeated bupivacaine-doses. Group 3 had single-dose spinal anesthesia with bupivacaine. Hemodynamic data were recorded during a 1-hour follow-up.Results All patients were ASA II and between 56-81 years of age. Two patients dropped out due to failure to insert a spinal catheter. We found no significant change in any hemodynamic parameters in group 1 and 2. The patient in group 3 showed significant decrease in systemic vascular resistance, and arterial and central venous pressures. (table 1) No patients in group 1 achieved complete surgical anesthesia due to lack of anesthesia of the cranial part of the surgical incision.Conclusions Neither lumbosacral plexus block nor continuous spinal anesthesia affected any hemodynamic parameters in this pilot study on patients without severe comorbidity. The utilized lumbosacral plexus blockade did not provide complete surgical anesthesia for total hip replacement. Further studies are required to assess the hemodynamic effects of lumbosacral plexus blockade in patients with cardiovascular comorbidity.

AB - Background and Aims Patients scheduled for total hip replacement often presents cardiovascular comorbidity, which increases perioperative risk of complications. This pilot study aimed to compare lumbosacral plexus blockade with continuous and single-dose spinal anesthesia for surgical anesthesia in total hip replacement. We hypothesized that lumbosacral plexus blockade induced the least hemodynamic impact.Methods Eight patients for elective hip replacement were included following informed consent. Hemodynamic impact was assessed using pulse contour analyses of the femoral artery pressure. Group 1 had lumbosacral plexus blockade (lumbar plexus block, sacral plexus block and fascia transversalis plane block) with ropivacaine. Group 2 had continuous spinal anesthesia with repeated bupivacaine-doses. Group 3 had single-dose spinal anesthesia with bupivacaine. Hemodynamic data were recorded during a 1-hour follow-up.Results All patients were ASA II and between 56-81 years of age. Two patients dropped out due to failure to insert a spinal catheter. We found no significant change in any hemodynamic parameters in group 1 and 2. The patient in group 3 showed significant decrease in systemic vascular resistance, and arterial and central venous pressures. (table 1) No patients in group 1 achieved complete surgical anesthesia due to lack of anesthesia of the cranial part of the surgical incision.Conclusions Neither lumbosacral plexus block nor continuous spinal anesthesia affected any hemodynamic parameters in this pilot study on patients without severe comorbidity. The utilized lumbosacral plexus blockade did not provide complete surgical anesthesia for total hip replacement. Further studies are required to assess the hemodynamic effects of lumbosacral plexus blockade in patients with cardiovascular comorbidity.

M3 - Konferenceabstrakt til konference

Y2 - 13 September 2017 through 16 September 2017

ER -