Three Different Anaesthetic Techniques in Unilateral Elective Hip Surgeries (Combined Lumbosacral Plexus Block, Spinal and Epidural): A Comparative Study

To compare the adequacy of combined lumbosacral plexus block over subarachnoid block and epidural in terms of motor, sensory blockade, surgeon and patient satisfaction and time for first rescue analgesia for unilateral elective hip surgeries.

Study Objective: To determine the outcome of using combined lumbosacral plexus block in comparison with epidural and subarachnoid block, its effectiveness, safety and complications related to the procedure.

Materials and Methods: A single centred randomized, single-blinded study, conducted between May 2017 to October 2018, on 60 patients undergoing elective unilateral hip surgeries with 20 patients in each group (group I -combined lumbar and sacral plexus block, Group II - Epidural & Group III- Subarachnoid block). Patients belonging to the American Society of anaesthesiologists, physical status 1 & 2, aged between 18 – 60 years were enrolled for the study and distributed randomly into one of the three groups. Adequacy of block in terms of motor and sensory blockade, patient and surgeon satisfaction and time for the first analgesia were noted.

Results: Among 60 patients, the block was adequate in group III, compared to group II and group I. The total duration of analgesia was significantly higher in group I (338.5 ± 44.51), compared to group II (135.5 ± 11.45) and group III (141.0 ±17.44). The total doses of analgesic required in the first 24 hours were low in group I when compared to group II and group III.

Conclusion: Combined lumbosacral plexus block, is a good and safe alternative to neuraxial block for patients undergoing unilateral hip surgeries, with good patient, surgeon satisfaction and prolonged postoperative pain relief.