A case report: the use of ultrasound guided peripheral nerve block during above knee amputation in a severely cardiovascular compromised patient who required continuous anticoagulation

Although lower-extremity surgeries are mainly performed under general or central neuraxial anesthesia, ultrasound-guided peripheral nerve block (PNB) can be a good alternative, especially for patients who require continuous anticoagulation treatment and present with poor cardiovascular conditions. T...

Full description

Saved in:
Bibliographic Details
Published in:Medicine (Baltimore) 2018-03, Vol.97 (9), p.e9374-e9374
Main Authors: Karm, Myong-Hwan, Lee, Sohee, Yoon, Syn-Hae, Lee, Sukyung, Koh, Wonuk
Format: Article
Language:English
Subjects:
Amputation - adverse effects
Amputation - methods
Anesthetics, Local
Anticoagulants - therapeutic use
Clinical Case Report
Critical Illness - therapy
Female
Humans
Middle Aged
Nerve Block - adverse effects
Nerve Block - methods
Ultrasonography, Interventional - methods
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Although lower-extremity surgeries are mainly performed under general or central neuraxial anesthesia, ultrasound-guided peripheral nerve block (PNB) can be a good alternative, especially for patients who require continuous anticoagulation treatment and present with poor cardiovascular conditions. The patient required continuous anticoagulation treatment due to the high risk of thromboembolism and poor cardiovascular conditions. The patient required lower-extremity amputation due to atherosclerotic and thromboembolic obstruction. We decided to progress the operation under peripheral nerve block. The sciatic, femoral, lateral femoral cutaneous nerve and anterior branch of the obturator nerve were blocked under ultrasound guidance. Sixty ml of a local anesthetic (equal mix of 1% lidocaine and 0.375% ropivacaine) was administered for the block. Sufficient sensory block at the area of amputation was obtained, and the patient's vital signs were stable throughout surgery. Ultrasound-guided peripheral nerve block can be an excellent anesthetic technique for patients receiving radical surgery at the proximal lower extremities, especially patients who are critically ill and considered high risk.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000009374