Abstract
Background: The use of psoas compartment block provides good analgesia but poor surgical anaesthesia. In Ortho-geriatric care different nerve blockade had been used to avoid the systemic adverse effect of centrally acting agents and provide long duration of unilateral limb analgesia after arthroplasty.
Aim: The aim of the study is to establish the quality of pain control, incidence of side effects and complications achieved with a psoas compartment block (PCB) following surgery for fractured neck of femur.
Study design: Prospective, Non randomised, longitudinal, Cohort. A Pilot Study period January 2003 -December 2004
Materials & Method: 10 patients of mean age 74.8 years (Range 23–93), 3 males and 9 females had unilateral hip surgery with general or a spinal (with no intrathecal opiate administration) as the main anaesthesia and a psoas Compartment Block for continuous infusion of bupivacaine for postoperative pain control (a total dose of 2mg/kg given in theatre and received a continuous infusion of bupivacaine 0.1% at a rate of 25ml/hour for 48 hours) and assessed by nurse led pain team.
Result & analysis: All the patients in this study group had excellent pain control. On the first post operative day only one patient had mild pain, and another had moderate pain. On the second day 3 patients had mild pain [chart 1].
Conclusion: These patients had excellent to good post operative pain control without having any adverse side effects. This study will help us to treat pain among elderly geriatric patients particularly in the demented group in immediate post-operative period. We need randomised comparative study to advocate this practice.
Correspondence should be addressed to The Secretary, BHS, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
