Articles Vol. 66 No. CĐ13- HNKH Gây mê Hồi sức 25/09/2025

44. PRELIMINARY ASSESSMENT OF THE EFFECTIVENESS OF COMBINED FASCIA ILIACA BLOCK AND LOW-DOSE SPINAL ANESTHESIA IN HIP REPLACEMENT SURGERY FOR FRAIL ELDERLY PATIENTS

Nguyen Thi Thuy1,2, Nguyen Huu Tu3,4, Nguyen The Anh1,2, Le Sau Nguyen1,2, Dao Thu Trang1,2
1 Friendship Hospital
2 Bệnh viện Hữu Nghị
3 Hanoi Medical University
4 Trường Đại học Y Hà Nội
Corresponding author: thuy.umhp@gmail.com
DOI: 10.52163/yhc.v66iCD13.3210
20 Views
17 Downloads
Keywords
Fascia iliaca block, low-dose spinal anesthesia, hip replacement, elderly, frailty.
Abstract

Objective: To evaluate the effectiveness of combining fascia iliaca block and low-dose spinal anesthesia for hip replacement surgery in frail elderly patients at Friendship Hospital from January 2025 to June 2025.

Methods: An interventional, uncontrolled, descriptive case series study.

Results: A total of 15 elderly patients (≥ 80 years old) with frailty (Fried score ≥ 3/5 points) who were indicated for hip replacement surgery (either partial or total) due to trauma were selected for the study. The success rate of the technique was 93.3%; the incidence of severe hypotension was 6.7%. The ANI at the time of skin incision was 84.2 ± 10.5 points; the ANI at the time of skin closure was 80.5 ± 9.2 points. The need for emergency analgesic medication during surgery was 6,7%. Complete lower limb motor blockade occurred in 93,3% of cases. The duration of postoperative analgesia was 8.1 ± 1.5 hours.

Conclusion: The combination of fascia iliaca block and low-dose spinal anesthesia for hip replacement surgery in frail elderly patients shows a high success rate, reduces intraoperative severe hypotension, and provides effective postoperative pain relief.

References
[1]
Clegg A, Young J, Iliffe S et al. Frailty in elderly people. Lancet, 2013 Mar 2, 381 (9868): 752-62. Google Scholar
[2]
Ferreira A.C, Hung C.W, Ghanta R.B et al. Spinal anesthesia is a grossly underutilized gold standard in primary total joint arthroplasty: propensity-matched analysis of a national surgical quality database. Arthroplasty, 2023 Feb 9, 5 (1): 7. Google Scholar
[3]
Almeida C.R, Vieira L. Combination of a deep fascia iliaca block with ultra-low dose spinal anesthesia for hip fracture surgery. Can J Anaesth, 2022 Mar, 69 (3): 402-404. Google Scholar
[4]
Zhang A, Gao H, Lu Y, Jiang L et al. Fascia Iliaca Block Combined with Low-dose Spinal Anesthesia for Hip Fracture Surgery in the Elderly: Effects on Severe Hypotension and Analgesia. A Randomized Controlled Trial. Pain Physician, 2024 Jul, 27 (5): E579-E587. Google Scholar
[5]
Ben-David B, Frankel R et al. Minidose Bupivacaine-Fentanyl spinal anesthesia for surgical repair of hip fracture in the aged. Anesthesiology, 2000 January 1, 92 (1): p. 6. Google Scholar
[6]
Almeida C.R, Vieira L. Combination of a deep fascia iliaca block with ultra-low dose spinal anesthesia for hip fracture surgery. Can J Anesth/J Can Anesth, 2022,69, 402-404. Google Scholar
[7]
Boselli V, Bouvet L, Allaouchiche B. Analgesia monitoring using Analgesia/Nociception Index: Results of clinical studies in awake and anesthetized patients. Prat. Anesth. Reanim, 2015, 19 (2), 78-86. Google Scholar
[8]
Zhang X.Y, Ma J.B. The efficacy of fascia iliaca compartment block for pain control after total hip arthroplasty: a meta-analysis. J Orthop Surg Res, 2019 Jan 25, 14 (1): 33. Google Scholar