Combined fascia iliaca compartment block and monitored anesthesia care for geriatric patients with hip fracture: Two case reports
作者机构：Department of AnesthesiologyLu’an Affiliated Hospital of Anhui Medical UniversityAnhui Medical UniversityLu’an 237005Anhui ProvinceChina
出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)
年 卷 期：2021年第9卷第27期
页 面：8268-8273页
核心收录：
学科分类：1002[医学-临床医学] 10[医学] 100217[医学-麻醉学]
主 题：Fascia iliaca compartment block Monitored anesthesia care Geriatric Hip fracture Ultrasound-guided Case report
摘 要：BACKGROUND Major hip surgery usually requires neuraxial or general anesthesia with tracheal intubation and may be supplemented with a nerve block to provide intraoperative and postoperative pain relief.CASE SUMMARY This report established that hip surgical procedures can be performed with a fascia iliaca compartment block(FICB)and monitored anesthesia care(MAC)while avoiding neuraxial or general anesthesia.This was a preliminary experience with two geriatric patients with hip fracture,American Society of Anesthesiologists status III,and with many comorbidities.Neither patient could be operated on within 48 h after admission.Both general anesthesia and neuraxial anesthesia were high-risk procedures and had contraindications.Hence,we chose nerve block combined with a small amount of sedation.Intraoperative analgesia was provided by single-injection ultrasound-guided FICB.Light intravenous sedation was added.Surgical exposure was satisfactory,and neither patient complained of any symptoms during the procedure.CONCLUSION This report showed that hip surgery for geriatric patients can be performed with FICB and MAC,although complications and contraindications are common.The anesthetic program was accompanied by stable respiratory and circulatory system responses and satisfactory analgesia while avoiding the adverse effects and problems associated with either neuraxial or general anesthesia.
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