1Department of Anesthesiology, Kaohsiung Medical University Hospital, Kaohsiung
2Department of Anesthesiology, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Pulmonary hypertension is a well-known risk for perioperative mortality and morbidity and may induce sudden postoperative death. Hip fracture surgery is also considered as a high-risk operation because patients requiring such surgery are usually elderly with multiple comorbidities. Herein, we present a 66-year-old woman who suffered from right femoral neck fracture and underwent bipolar arthroplasty. Her underlying diseases included chronic obstructive pulmonary disease and diabetes. Preoperative echocardiography showed pulmonary hypertension. Ultrasound-guided fascia iliaca block was performed followedby epidural anesthesia.Adequate anesthesia, stable intraoperative hemodynamics and well postoperative pain management were achieved by combination of two techniques, then she was transferred to the intensive care unit and no postoperative adverse event was observed. The case suggests that fascia iliaca block might be considered for perioperative analgesia for the management of patients with pulmonary hypertensionand femoral neck fracture. FICB could also be used as an adjuvant to epidural anesthesia for both excellent block quality and hemodynamic stability.
fascia iliaca block, pulmonary hypertension, bipolar hemiarthroplasty