Deep fascia iliaca block combined with sacral plexus block for hip fracture surgery: A retrospective series of cases

Abstract

This case series describes a novel anaesthetic approach for hip fracture surgery using the deep fascia iliaca block combined with the sacral plexus block. This single-centre, retrospective study involved 15 patients aged 85 years or older and having significant cardiac disease. All the patients were managed with single-shot deep fascia iliaca block (22 or 25 ml of ropivacaine 0.5%) and sacral plexus block (12 or 15 ml of ropivacaine 0.5%, according to the patients' weight) after the administration of 50 μg of fentanyl intravenously. Intraoperatively, the patients were also administered light-to-moderate sedation. All patients presented a successful sensory block and a high level of haemodynamic stability (nil vasopressor consumption). In hip fracture surgery, low volume deep fascia iliaca block may be combined with sacral plexus block as primary anaesthetic technque, without any neuraxial technique or sympathetic blockade.

Keywords: Deep fascia iliaca block; analgesia; cardiac disease; hip fracture; sacral plexus block.