Severe Aortic Stenosis: Combined Lumbar Plexus, Sciatic and Iliohypogastric Nerve Block with 0.25% Levobupivacaine for Reduction of Hip Fracture

The potential advantages of 0.25% concentration of levobupivacaine in performing lumbar plexus with sciatic and iliohypogastric nerve block in patients with aortic stenosis is emphasized in this case report. A 48-yr old male patient who was scheduled for hip fracture surgery had severe aortic stenosis with aortic valve gradient of 85 mmHg. Anesthesia plan was combined lumbar plexus, sciatic and iliohypogastric nerve block with a total of 60 mL, 0.25% levobupivacaine. After performing the blocks, the patient underwent successful and uneventful hip reduction surgery except requiring only sedation medications. The patient had sufficient anesthesia and remained hemodynamically stable without the use of vasoconstrictive medication during the operation. We thought that combined lumbar plexus, sciatic and iliohypogastric nerve block with 0.25% levobupivacaine provides stable hemodynamic parameters with adequate anesthesia for hip fracture surgery in patient with severe aortic stenosis.