Introduction: Hip fracture is a pathological condition, more common in older
age, i.e. in people over 65 years. The prevalence of this disorder is
continuously increasing, simultaneously with higher age limit. In evaluation
of risk for operation and anesthesia, older age itself represents higher risk
and calls for special attention. In selection of anesthesiological technique,
it is more usual to apply neuroaxial block or peripheral nerve block, which
is more advantageous over general anesthesia. CASE REPORT: A female, 80-year
old, patient B.D. was admitted to hospital for hip fracture, with the
diagnosis of the right, lateral, basicervical femoral fracture. On admission,
heart decompensation (decompensated dilated myocardiopathy), pulmonary edema
and the left lateral pleural effusion were established. Due to high risk (ASA
III) of intraoperative and postoperative complications, it was decided to
apply combined peripheral nerve block. Using the neurostimulators, 3-in-1
block, lumbosacral block and sciatic nerve block were applied. During the
operation, the patient was sedated by Propofol and had spontaneous
respiration through the laryngeal mask. Intra- and postoperatively, the
patient?s hemodynamics was stable. Conclusion: Peripheral nerve blocks are
safe and effective anesthesiological technique, which may reduce the
mortality in patients with the hip fracture and maintain the hemodynamic
stability, both during and after the surgical intervention.
Survey of Current Practices: Peripheral Nerve Block Utilization by ED Physicians for Treatment of Pain in the Hip Fracture Patient Population