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(a). A pubic ramus was identified between the the iliopubic eminenece and the aterior inferior iliac spine, and a catheter was mounted between the pubic ramus and psoas tnedon. Figure 1(b). 20 ml of 0.375% ropivacaine was injected between the psoas tendon and the pubic ramus. Fluid filling is seen between the psoas tendon and the pubic ramus. Figure 1(c). PA image when the hip joint was checked by administering a contrast agent using fluoroscopy. It is observed that the contrast medium is spread along the iliopsoas muscle passing around the hip joint. Fig. 1(d). Lateral image when the hip joint was checked by administering a contrast agent using fluoroscopy. It was confirmed that the iliopsoas muscle running along the anterior side of the hip joint was imaged. FA:Femoral artery, FN:femoral nerve, PT:psoas tendon, AIIS:anterior inferior iliac spine, LA:local anesthetics, GT:greater trochanter, FH femoral head, Asterisk:contrasat media, arrow:catheter
(a). A pubic ramus was identified between the iliopubic eminenece and the aterior inferior iliac spine, and the catheter was mounted between the pubic ramus and psoas tnedon. Fig. 2(b). 0.375% ropivacaine was injected between the psoas tendon and the pubic ramus. As the fluid fills between the psoas tendon and the pubic ramus, it is seen that the interspace expands. Fig. 2(c). PA image when the hip joint was checked with administering a contrast agent using fluoroscopy. It is observed that the contrast medium is spread along the iliopsoas muscle passing around the hip joint. Fig. 2(d). A lateral image when the hip joint was checked with administering a contrast agent using fluoroscopy. It was confirmed that the iliopsoas muscle running along the anterior side of the hip joint was imaged. FA:Femoral artery, FN:femoral nerve, PT:psoas tendon, AIIS:anterior inferior iliac spine, LA:local anesthetics, GT:greater trochanter, FH femoral head, Asterisk:contrasat media, arrow:catheter
Background and Aims There are several methods for pain control in hip fracture patients. Recently, a pericapsular nerve group block was introduced. This block is very effective for pain control in hip fracture patients, and there is a report that it is very effective for pain control after surgery, especially in the case of continuous pericapsular nerve group blocks. We would like to discuss a more effective and accurate way to perform the pericapsular nerve group block.
Methods Two cases were administered. Both cases were hip fracture patients and ultrasound-guided continuous pericapsular nerve group block was performed. We also checked the fluoroscopic image using a contrast medium to recheck how the drug spreads and to confirm the appropriate position of the catheter. Postoperative pain was confirmed by a numerical rating scale, and complications such as motor weakness were also checked.
Results In both cases, low NRS was checked after surgery, and no complications occurred.
Conclusions If it is confirmed that the drug spreads well between the psoas tendon and the pubic ramus and the space between the psoas tendon and the pubic ramus is widened when injecting the drug, it can be considered an effective block.