Compartment Psoas Block Efficacy and Safety
Compartment Psoas Block Efficacy and Safety
A randomized controlled trial to assess the efficacy and safety of the prolonged compartment
 psoas block for analgesia and anesthesia for femur surgery in the elderly
A randomized controlled trial was conducted from January 2018 to August 2019 at the Into-Sana
 Medical Center (Odessa, Ukraine). The study design was approved by the Ethical Committee at
 Bogomolets National Medical University. Patients who planned osteosynthesis of the proximal
 femur and who met the inclusion criteria were randomized to 3 study groupsThe aim of our
 study was to compare the effectiveness and safety of different techniques of perioperative
 anaesthesia and anaesthesia in patients with fractures of the proximal femur: general
 anaesthesia and systemic analgesia, neuraxial (spinal) anaesthesia, compartment psoas block
 in combination with a sciatic nerve block. Patients in group 1 underwent catheterization of
 the lumbar plexus from the posterior access on admission to the hospital and began analgesia
 with bupivacaine 0.125% 6-8 ml / h. Intraoperative anesthesia was provided with a bupivacaine
 bolus of 0.5% 200 mg in a lumbar catheter and a sciatic nerve block with 1.5% 450 mg of
 lidocaine. Postoperative analgesia was provided with prolonged lumbar plexus block with
 bupivacaine 0.125% 6-8 ml / h.

 Patients in group 2 underwent intraoperative spinal anaesthesia at the level of L3-L4 with
 hyperbaric bupivacaine 10-15 mg. Patients in groups 1 - 2 receive intraoperative sedation
 with propofol 1% with a target level of sedation RASS from 0 to -2. Group 3 patients
 underwent general sevoflurane inhalation anaesthesia with fentanyl infusion for analgesia.

 All patients received paracetamol 3g/day and dexketoprofen 75 mg/day during hospitalization.
 On-demand, nalbuphine 5 mg SC was used for analgesia.
Inclusion Criteria:

 -proximal femur fracture

 Exclusion Criteria:

 -  pregnancy and lactation

 -  history of opiate addiction

 -  traumatic brain injury

 -  acute cerebrovascular accident

 -  chronic heart failure (New York Heart Association Functional Classification, NYHA,
 class III-IV)

 -  respiratory failure

 -  renal failure with decreased creatinine clearance less than 30 ml / min / 1.73 m2

 -  hepatic insufficiency class C according to Child-Pugh).