Modified LPB and SPB vs Classical LPB and SPB

Chinese Academy of Medical Sciences & Peking Union Medical College

Status: Enrolling

Conditions: Anesthesia, Local

Treatments: Procedure: Combined anterior lumbar plexus and lateral sacral plexus block in a classical position.; Procedure: Combined anterior lumbar plexus and lateral sacral plexus block in a semi-supine position

Study type: Interventional

Funder types: Other

Identifiers

NCT05901415

K3105

Details and patient eligibility

About

The timing of surgery for hip fractures is crucial for elderly patients. The mortality rate for elderly patients after hip fracture is high, and anesthetic decisions significantly affect the patient's outcome. Regional anesthesia has been shown to have better outcomes than general anesthesia. We proposed a newly developed modified position for the ultrasound-guided combined anterior lumbar and lateral sacral plexus block technique that offers benefits, including minimizing interference with circulation and anesthesia, avoiding position change and pain, and providing effective postoperative analgesia.

Full description

The increasing proportion of elderly patients requiring surgery, particularly for hip fractures, is common among the elderly. The timing of surgery for hip fractures is crucial and most require surgical treatment. The mortality rate for elderly patients after hip fracture is high, and anesthetic decisions significantly affect the patient's outcome. Elderly patients have decreased physiological function and are more susceptible to postoperative complications, such as delirium, constipation, pressure sores, and catheter-related infections. Regional anesthesia has been shown to have better outcomes than general anesthesia. We proposed a newly developed modified position for the ultrasound-guided combined anterior lumbar and lateral sacral plexus block that offers benefits, including minimizing interference with circulation and anesthesia, avoiding position change and pain, and providing effective postoperative analgesia. The study validates the feasibility and effectiveness of this technique for elderly hip fracture surgery and compares it with a traditional lumbar-sacral plexus nerve block, providing a fresh perspective on anesthesia for this type of surgery.

Enrollment: 30 estimated patients

Sex: All

Ages: 70 to 100 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Patients over 70 years of age. ASA classification grades II-IV. Patients with hip fractures requiring surgery (intramedullary nailing of intertrochanteric fractures).

Exclusion criteria

Peripheral neuropathy or other neurological disorders affecting the nerves involved in the block; Serve coagulopathy or platelet dysfunction; Inability to perform puncture due to infection, wound, or other reasons at the puncture site; Allergy to local anesthetics or any other medications used in the block; Inability to cooperate or communicate with the healthcare provider during the procedure; Patients or their families who cannot understand the conditions and objectives of the study.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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30 participants in 2 patient groups

A Modified Semi-supine Position of Combined Anterior Lumbar and Lateral Sacral Plexus Block

Experimental group

Description:

Patients were placed in a supine position with a small pad put under the upper body at the surgical side, then they received a combined anterior lumbar and lateral sacral plexus block.

Treatment:

Procedure: Combined anterior lumbar plexus and lateral sacral plexus block in a semi-supine position

A classical Position of Combined Anterior Lumbar and Lateral Sacral Plexus Block

Sham Comparator group

Description:

Patients received a combined anterior lumbar and lateral sacral plexus block in a lateral position.

Treatment:

Procedure: Combined anterior lumbar plexus and lateral sacral plexus block in a classical position.