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Abstract
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Background and Aims Hip surgeries are usually done as in patients with three to five days of hospital stay. For pain relief, different regional techniques are being used, such as lumbar plexus blocks, femoral nerve blocks, and fascia iliaca blocks, which are effective but have undesirable lower limb weakness. Here, we present a case of a 77-year-old female ASA class II patient on whom total hip replacement surgery was done under spinal anaesthesia along with a motor-sparing PEricapsular Nerve Group block and she was discharged on the same day with almost no pain.
Methods After giving the spinal anesthesia using heavy prilocaine, a PEricapsular Nerve Group block was given under USG guidance using an 80 mm needle via an in-plane approach, instilling 15 mL of 0.25% bupivacaine over the superior pubic rami, appreciating the lifting up of psoas while instilling the drug. Later, the Lateral Femoral Cutaneous Nerve Block was also given by depositing 5 ml of 0.25% bupivacaine around the LFCN nerve over the sartorius.
Results She was assessed in the ward 4-5 hours after surgery, and she was able to walk comfortably with no motor weakness and almost no pain and she was discharged home by evening.
Conclusions The international trend to reduce the length of stay for surgical patients also applies to hip surgeries and this technique may help us in setting a routine of early mobilization and early discharge of hip replacement surgical patients as well and also reduce the cost utilization of the trust.
PENG Block