Background and aims In this study we aimed to showed our successful experience with lumbar erector spinae plane (ESP) block as a main anesthetic technique in fifteen high risk elderly patients undergoing hip surgery with mild propofol sedation. Also we demonstrate magnetic resonance images and discuss the anatomic basis of lumbar ESP block.

Methods This study was conducted at Istanbul Maltepe University and Erzurum Ataturk University Faculties of Medicine. This study includes patients that fit the aforementioned description and gave written informed consent for L-ESPB with mild sedoanalgesia to be used as the primary anesthesia technique and underwent hip surgery.

Results All patients’ surgeries were completed without requirement for general anesthesia or local anesthesia infiltration of the surgical site. Surgical time, perioperative propofol and intraoperative ketamine requirement are shown in table 1. All patients’ NRS score were <2/10 in the recovery room. Significant contrast spread was observed between the Th12 and L5 transverse process and erector spinae muscle and between multifidus muscle and iliocostal muscle at the L2-4 levels. Contrast material was observed at the anterior of the transverse process spreading to the paravertebral, foraminal and partially epidural area/spaces and also in the areas where the lumbar nerves enter the psoas muscle (figure 1).

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Abstract ESRA19-0510 Figure 1

Conclusions Lumbar erector spinae plane block when combined with mild sedoanalgesia provides adequate and safe anesthesia in high risk and advanced aged patients undergoing hip surgery. Larger controlled studies as well as comparisons with other regional anesthesia techniques are required.