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首页> 外文期刊>麻酔 >Combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in four patients with severe heart failure
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Combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in four patients with severe heart failure

机译：椎旁腰丛和para骨旁坐骨神经阻滞联合治疗4例严重心力衰竭患者的髋部骨折

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We experienced four cases of anesthesia for hip fracture reduction in patients with severe heart failure, where anesthesia was attempted with combined paravertebral lumbar plexus and parasacral sciatic nerve block instead of spinal anesthesia. The anesthesia was successful without any sequelae. The patients' characteristics are as follows. Case 1: 97-year-old woman with severe heart failure and old myocardial infarction. Case 2: 91-year-old man with pacemaker, heart failure and heart valve disease. Case 3: 93-year-old woman with severe heart failure and multi-vessel coronary artery stenosis. Case 4: 83-year-old woman with congestive heart failure and heart valve disease. Paravertebral lumbar plexus block was performed with Touhy needle which was directed to lumbar transverse process, then re-directed caudally. Psoas compartment was felt with loss of resistance. Twelve ml of 0.25% bupivacaine was injected. Sciatic nerve block was performed with a needle which was inserted at the midpoint between the greater trochanter and the sacral hiatus without (case 1, 2) or with nerve stimulator (case 3, 4). Eight ml of 0.25% bupivacaine was injected. During the anesthesia, propofol was injected for light sedation. Although this combined nerve block is difficult to perform compared with spinal anesthesia, this could be applicable for hip fracture reduction anesthesia, especially in patients with severe heart failure.
机译：我们在严重心力衰竭患者中经历了四例麻醉以减少髋部骨折，其中尝试合并椎旁腰丛和s骨坐骨神经阻滞而不是脊麻麻醉。麻醉成功，没有任何后遗症。患者的特征如下。病例1：97岁的妇女患有严重的心力衰竭和老年心肌梗塞。案例2：91岁的男子患有起搏器，心力衰竭和心脏瓣膜疾病。病例3：93岁的女性，患有严重的心力衰竭和多支冠状动脉狭窄。病例4：83岁的女性患有充血性心力衰竭和心脏瓣膜疾病。用Touhy针进行椎旁腰丛神经阻滞，将其定向至腰椎横突，然后尾向重新定向。感觉到腰大肌室抵抗力下降。注射了12 ml的0.25％布比卡因。坐骨神经阻滞是通过在大转子与and骨裂孔之间的中点插入一个针来进行的（无病例1、2）或有神经刺激器（病例3、4）。注射八毫升的0.25％布比卡因。在麻醉期间，注射异丙酚以进行轻度镇静。尽管与脊柱麻醉相比，这种联合神经阻滞很难执行，但它可用于减少髋部骨折的麻醉，特别是在患有严重心力衰竭的患者中。

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