Continuous Lumbosacral Plexus Blocks for Hip and Femur Surgery Analgesia in Elderly Patients Using a Neurostimulator. A Retrospective Study Comparing Psoas and Inguinal Compartment Access

Authors

  • Luiz Eduardo Imbelloni esearcher without Institution, Anesthesiologist at various Hospitals, Rio de Janeiro, RJ, Brazil. Author
  • Anna Lúcia Calaça Rivoli Anesthesiologist at the National Cancer Institute (INCA), Rio de Janeiro, RJ, Brazil Author
  • Sylvio Valença de Lemos Neto Head of the Anesthesiology Service of the National Cancer Institute (INCA) Anesthesiologist, Responsible for the CET-SBA of the National Cancer Institute, Rio de Janeiro, RJ, Brazil Author
  • Ana Cristina Pinho INCA Anesthesiologist, Co-Responsible for the CET-SBA of the National Cancer Institute, Rio de Janeiro, RJ, Brazil Author
  • Antonio Fernando Carneiro Professor of Anesthesiology at the UFG Faculty of Medicine, Responsible for the CET-SBA of the HCUFG, Goiânia, GO, Brazil Author
  • Felipe Bufaiçal Rassi Carneiro Anesthesiologist of Hospital Anis Rassi, Goiânia, GO, Brazil Author
  • Geraldo Borges de Morais Filho Master’s in Labor Economics, UFPB, João Pessoa-PB, PhD Student in Applied Mathematics and Modeling, Universidade Aberta de Lisboa, Portugal Author

DOI:

https://doi.org/10.47363/JSAR/2025(6)255

Keywords:

Continuous Lumbar Plexus, Psoas Compartment, Inguinal Compartment, Orthopedic Surgery, Local Anesthetic, Infusion Pumps, Spinal Anesthesia

Abstract

Background: Lumbar plexus block has been used effectively as an anesthetic technique for anesthesia and analgesia in elderly patients with femur and hip fractures. Access to the lumbar plexus can be achieved via a posterior approach (within the psoas compartment) or an anterior approach (in the inguinal compartment), with single short administration or continuous infusion of local anesthetic. The aim of this retrospective study was to compare the analgesic efficacy of an elastomeric pump in two access points, identified by neurostimulation, and its complications.

Method: This study was recorded in an Excel spreadsheet from July 2010 to February 2019, including 100 patients over the age of 60 years old who underwent corrective surgery for femur or hip fractures underwent continuous lumbar plexus block for postoperative analgesia. An elastomeric pump was used with 400 ml of 0.1% levobupivacaine excess of enantiomeric solution, at a flow rate of 10 ml/hour. A pain scale (grades 0 to 3) was used, assessed in the anterior thigh region at 4, 8, 12, 16, 20, 24, 30, and 40 hours.

Results: There was a predominance of females (77%) compared to males (23%). Access to both compartments was achieved with neurostimulation and catheter placement, successfully in all 100 patients. No complications occurred. The best analgesic outcome was obtained with the psoas compartment. T here was no bacterial growth upon catheter removal.

Conclusion: The retrospective study showed that there was significant difference, the quality of analgesia is better with the catheter installed in the psoas compartment compared to inguinal access. In both approaches, there were no postoperative complications.

Author Biographies

  • Luiz Eduardo Imbelloni, esearcher without Institution, Anesthesiologist at various Hospitals, Rio de Janeiro, RJ, Brazil.

    Luiz Eduardo Imbelloni, Researcher without Institution, Anesthesiologist at various Hospitals, Rio de Janeiro, RJ, Brazil.

  • Anna Lúcia Calaça Rivoli, Anesthesiologist at the National Cancer Institute (INCA), Rio de Janeiro, RJ, Brazil

    Anna Lúcia Calaça Rivoli, Anesthesiologist at the National Cancer Institute (INCA), Rio de Janeiro, RJ, Brazil

  • Sylvio Valença de Lemos Neto, Head of the Anesthesiology Service of the National Cancer Institute (INCA) Anesthesiologist, Responsible for the CET-SBA of the National Cancer Institute, Rio de Janeiro, RJ, Brazil

    Sylvio Valença de Lemos Neto, Head of the Anesthesiology Service of the National Cancer Institute (INCA) Anesthesiologist, Responsible for the CET-SBA of the National Cancer Institute,  Rio de Janeiro, RJ, Brazil

  • Ana Cristina Pinho, INCA Anesthesiologist, Co-Responsible for the CET-SBA of the National Cancer Institute, Rio de Janeiro, RJ, Brazil

    Ana Cristina Pinho, INCA Anesthesiologist, Co-Responsible for the CET-SBA of the National Cancer Institute, Rio de Janeiro, RJ, Brazil

  • Antonio Fernando Carneiro, Professor of Anesthesiology at the UFG Faculty of Medicine, Responsible for the CET-SBA of the HCUFG, Goiânia, GO, Brazil

    Antonio Fernando Carneiro, Professor of Anesthesiology at the UFG Faculty of Medicine, Responsible for the CET-SBA of the HCUFG, Goiânia, GO, Brazil

  • Felipe Bufaiçal Rassi Carneiro, Anesthesiologist of Hospital Anis Rassi, Goiânia, GO, Brazil

    Felipe Bufaiçal Rassi Carneiro, Anesthesiologist of Hospital Anis Rassi, Goiânia, GO, Brazil

  • Geraldo Borges de Morais Filho, Master’s in Labor Economics, UFPB, João Pessoa-PB, PhD Student in Applied Mathematics and Modeling, Universidade Aberta de Lisboa, Portugal

    Geraldo Borges de Morais Filho, Master’s in Labor Economics, UFPB, João Pessoa-PB, PhD Student in Applied Mathematics and Modeling, Universidade Aberta de Lisboa, Portugal

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Published

2025-11-25

Issue

Vol. 6 No. 11 (2025): Volume 6 Issue 11

Section

Articles