Psoas compartment block for hip arthroplasty was evaluated clinically in 32, either sex, geriatric patients. To perform the block, the patient was placed in a lateral decubitus position and a line was drawn, connecting both iliac crests
(intercristal
line). 22G teflon-coated needle of 10cm-length was inserted at a point 3cm caudad to the intercristal line and 5cm lateral to the spinal midline on the side to be blocked. The nerve stimulator (1-3mA, 1Hz), Pajunk(r) (GMBH, Geisingen,
West-Germany), was
used to elicit paresthesia or muscle twitching on the patient's ipsilateral leg. The block was performedwith administration of a mixture of 15 ml of 1.5% lidocaine, 15 ml of 0.5% bupivacaine and 0.15 mg of epinephrine.
The onset time of the block was 4.4±1.6 minutes and its duration was 3.8±1.5 hours. The mean value of the lowest mean arterial pressure during the first 1 hour after the injection of local anesthetics, 85.7±9.8 mmHg was lower, compared to the
preanesthetic baseline value, 98.2±16.5 mmHg. The failure rate was 9.4% and any significant systemic toxicity was not seen. There were some intraoperative complaints such as the discomfort due to position bars. However, there was no remarkable
problem
intraoperatively.
The results indicate the psoas compartmentblock is a recommendable safe anesthetic technique for hip arthroplasty in geriatric patients.
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