A 72-year-old female with severe heart failure due to rheumatoid myocarditis underwent open reduction of the left femoral neck (trochanteric) fracture. We performed psoas compartment block (PCB) at L3/4 level in the lateral position with the fractured side up, using a 22 G Tuohy needle to inject 10 ml of normal saline and 20 ml of 2% mepivacaine. Anesthesia was maintained with propofol (1-2 mg.kg-1.hr-1) under spontaneous breathing with oxygen (2 l.min-1) through mask. The patient did favorably during and after the operation. We conclude that PCB is useful for surgery of the lower extremity in patients with heart failure.

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