Kalça Kırıklarında Ağrı Yönetiminde Kullanılan Periferik Bloklar
Synopsis
Hip fractures have become a serious health problem with the growing elderly population, leading to severe pre- and postoperative pain that reduces quality of life, delays mobilization, and increases the risks of delirium and mortality. Comorbidities accompanying advanced age, such as dementia, renal, or cardiac disorders, combined with serious side effects of conventional systemic analgesics like paracetamol, NSAIDs, and narcotics—including respiratory depression, confusion, gastrointestinal bleeding, and organ toxicity—limit the use of systemic pain management. Consequently, ultrasound-guided regional peripheral nerve blocks stand out in emergency departments and orthopedic wards as effective alternatives that reduce opioid requirements, prevent delirium, and provide safe analgesia. The text details key peripheral block techniques used in managing pain from hip and femoral fractures: Lumbar Plexus Block (LPB) targets the femoral, lateral femoral cutaneous, and obturator nerves within the psoas compartment; Fascia Iliaca Compartment Block (FICB) is noted for its low complication risk and ease of application; Femoral Nerve Block (FNB) provides practical and effective pain control in the groin area; and Pericapsular Nerve Group (PENG) Block delivers dynamic analgesia by blocking the nerve branches innervating the anterior hip capsule without causing quadriceps motor weakness. In conclusion, ultrasound-guided peripheral blocks offer promising and safe methods for establishing standardized pain protocols in elderly patients with hip fractures.
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