الفهرس 
Lumbar Plexus BlockOnly 14 pages are availabe for public view
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Abstract
Modern anesthesiologists are concerned with both intraoperative and postoperative pain relief. They can provide best pain relief; as they are familiar with pharmacology of analgesics, pain pathways and skill for pain management modalities. Among painful conditions, fractures are common and fracture femur is common amongst elderly especially females because of osteoporosis. These patients are of geriatric age group and may have associated cardiac, respiratory and neurological problems which increases risk for perioperative and postoperative complications.
Regional anesthesia has much to offer to patient, surgeon and anesthesiologist due to simplicity of administration, preservation of consciousness, good analgesia, least side effects and improved intraoperative as well as postoperative pain relief. Spinal anesthesia in elderly patients can be associated with major hemodynamic changes. Contraindications to spinal anesthesia includes head injury with neurological damage, history of epilepsy, stenotic valvular diseases etc., whereas peripheral nerve blocks of lower limb can provide ideal perioperative analgesia because there is no hemodynamic instability or depression of pulmonary functions.
Upper limb anesthesia can be achieved with single block like interscalene block, supraclavicular block etc., while in case of lower limb this is not possible, because the nerves of the lower extremity are not bundled in a single fascial sheath and therefore separate injections are needed to adequately anesthetize all regions.