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B255 Suprailiac crest block in the management of pain in intramedullary nailing femur synthesis
  1. D Genco1,
  2. G Terranova1,
  3. G Prato2,
  4. V Cattaneo3 and
  5. PA Grossi1
  1. 1Istituto ortopedico Pini, Milano, Italy
  2. 2Università degli studi di Milano, Milano, Italy
  3. 3Università degli Studi di Brescia, Brescia, Italy


Background and Aims Analgesia in regional thight is frequently performed throught femoral nerve and lateral femoral-cutaneous blockade. Thight proximal lateral region is innervated by the iliohypogastric nerve and T12. The ultrasound-guided suprailiac crest (SIC) block is a novel technique usefull to provide analgesia.

A woman 76 years old, with a significant medical history which included autoimmune-thrombocytopenia and cardiovascular diseases, was firstly treated by gamma-nailing due to pertrochanteric fracture. Subsequently she was diagnosed with purulent dehiscence of the surgical wound. Since patient’s condition, we avoided general or spinal anesthesia and performed ultrasound-guided SIC block.

Methods With the patient in supine position, a linear transducer is placed over the superior-anterior iliac spine, transducer is tilted in the sagittal plane and moved laterally along the iliac crest passing through the greater trochanter. After identified the insertion of transversus abdominis, internal and external oblique muscles at the iliac crest and the planes between them, probe is tilted 90° above the iliac cresthe and needle is inserted in plane anterior to posterior to reach the fascia between the two oblique muscles. Associated to the femoral cutaneous nerve block, a full skin’s anesthesia in the superior lateral thigh region, from the iliac crest to the proximal third of the thigh, was obtained.

Results Surgery was conducted under sedation and locoregional anesthesia, no intraoperative pain was referred.

Conclusions SIC block provides an analgesic and specific anesthesia in the area left undercovered by the others nerve blocks. This could be an easy and safe technique, avoiding the use of other pharmacological strategies.

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