Combined Fascia Iliaca and Sacral Erector Spinae Plane Blocks for Hip Surgery in Hereditary Hemorrhagic Telangiectasia: A Case Report.

Abstract

Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia [HHT]) is a rare autosomal dominant vascular disorder characterized by mucocutaneous telangiectasias and arteriovenous malformations. A 47-year-old woman with recurrent epistaxis and telangiectasias underwent total hip arthroplasty for severe osteoarthritis. No visceral malformations were detected. General anesthesia combined with suprainguinal fascia iliaca and sacral erector spinae plane blocks provided effective intra- and postoperative pain management and minimized opioid use. Surgery and recovery were uneventful. This case underscores the importance of thorough preoperative evaluation and tailored anesthetic strategies in patients with HHT, given their increased risk of bleeding and systemic complications.