Combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in a patient with severe aortic stenosis.

PURPOSE: To report the use of a combined paravertebral lumbar plexus and parasacral sciatic nerve block for reduction of hip fracture in an elderly patient with severe aortic stenosis.

CLINICAL FEATURES: In an 87-yr-old lady with severe aortic stenosis and fracture of the right trochanter due to a fall, a combined right-sided paravertebral lumbar plexus and parasacral sciatic nerve block was used successfully for operative reduction of the fracture. A moderate amount of phenylephrine was required to maintain adequate systemic blood pressure despite the largely unilateral nature of the blocks.

CONCLUSION

Combined paravertebral lumbar plexus and parasacral sciatic nerve block can be a viable alternative to general anesthesia and epidural or spinal block for hip surgery in patients with severe aortic stenosis.