The Open Access Journal of Science and Technology

Abstract

Influence of Lumbar Plexus Block for Proximal Modular Mega prostheses in Metastatic Bone Disease of the Femur

Author(s): Mohammed Ben Aziz, Maher Khalife, Sonia Hontoir, Maurice Sosnowski, Michael Gebhart,and Fouad Aoun

Background Modular megaprosthesis for proximal femur reconstruction after wide resection of metastatic lesion is a long-lasting painful procedure associated with prolonged hospital stay and significant blood loss. We evaluated the influence of lumbarplexusblockonintraoperativeandpostoperativecomplicationsaswellaslengthofhospitalstay.Materials and Methods A retrospective study comparing two groups of patients for intraoperative and postoperative complications undergoing modular megaprosthesisformetastaticbonediseaseofthefemuraccordingtothetypeofanesthesiareceived.Group1included20patients undergoingtheprocedureundergeneralanesthesiaandgroup2had19patientsundergoingthesameprocedurebythesamesurgeon under general anesthesia combined to lumbar plexus block. Results The two groups were comparable in terms of demographic characteristicsandtheprimarylocationofthetumorexceptforsmokingandlungcancerwhichweremorefrequentingroup1. Intraoperative variables were not statistically different between the two groups except for intraoperative blood loss (P = 0.046) andtransfusion(P=0.007).Respiratorycomplicationsweremorefrequentinthegroup1comparedtogroup2(32%vs.0%,P= 0.006)whiletherewerenostatisticallysignificantdifferenceforlocalcomplications,postoperativeHbandLOS.Onmultivariate analysis,NSAIDsconsumptionandgeneralanesthesiawerefoundtobeandindependentpredictivefactorsforintraoperativeblood loss.AgeandASAscorewereindependentpredictivefactorsforprolongedLOS.Smokingandlungcancerwerepredictivefactors forrespiratorycomplications.Generalanesthesiaalonewasnotfoundtobeapredictiveriskfactorforrespiratorycomplications (P=0.245)andprolongedLOS(P=0.052).ConclusionLumbarplexusblockisaneffectivecomplementtogeneralanaesthesia andintraoperativeanalgesicmanagementofmodularmegaprosthesisforproximalfemoralmalignantlesions,reducingbloodloss andtransfusionduringthesurgicalprocedure.Prospectiverandomizedtrialsareneededtoconfirmthesefindings

Share this article