Surgery 2026

92-year-old woman admitted to hospital due to femur neck fracture. The decision to perform emergency hip replacement surgery was made. Patient had comorbidities: arterial hypertension III, heart insufficiency NYHA III, two times myocardial infarction, ischemic heart disease, two times ischemic stroke after which she had blindness, persistent atrial fibrillation, diabetes mellitus type II. She received digoxin, aspirin, enalapril and amaryl for treatment of chronic diseases. Patient’s physical status was ASA IVE, risk of surgery and anesthesia was high. We decided to provide surgery under psoas compartment block and informed consent from patient’s relatives was received. Psoas compartment block was performed using nerve stimulation technique. Perineural catheter inserted and local anesthetics 1% 20.0ml lidocaine and 0.5% 20.0ml ropivacaine injected through the catheter. Adequate analgesia received after 15min. Surgery and anesthesia - without complications. There was no discomfort of patient and vital parameters were stable during surgery. Duration of operation procedure – 70min., No additional analgesia and sedation was needed during and after surgery. Peripheral nerve catheter removed after 16h. without the need of additional injections. Patient discharged home without any complications.Conclusion. For hip replacement surgery, psoas compartment block is possible to use as an alternative of general or spinal anesthesia in selective cases.

Vakhtang Shoshiashvili has completed his PhD at the age of 30 years from All Union Cancer Research Center, Moscow. He is assistant professor, Department of anesthesiology and intensive care, TSMU, Tbilisi, Georgia. He has published more than 40 papers in reputed journals and has been serving as an editorial board member  in international medical journals such as Acta Scientific Medical Sciences (India), RACT, Scivision publishers (USA), BMMS.Ge (Georgia, European University).