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[Combined sciatic nerve-3 in 1 block in high risk patient]
P Marhofer1, K Schrögendorfer, H Andel
1Universitätsklinik für Anästhesiologie und Intensivmedizin, Universität Wien.
Summary
This case report details a combined sciatic and 3-in-1 nerve block for lower limb amputation in a critically ill patient. This regional anesthesia technique proved safe and effective for a hemodynamically unstable individual.
Area of Science:
- Anesthesiology
- Regional Anesthesia
- Surgical Procedures
Background:
- A 54-year-old male patient with end-stage peripheral vascular disease, diabetes mellitus, and toxic cardiomyopathy required lower limb amputation.
- The patient experienced cardiac arrest and cardiopulmonary resuscitation during a prior general anesthesia induction, classifying him as ASA IV-V.
Observation:
- The patient underwent a combined sciatic nerve block and 3-in-1 block under ultrasonographic guidance for the amputation.
- 20 mL of 1% mepivacaine was used for each block, achieving sufficient sensory blockade.
Findings:
- The patient remained hemodynamically and respiratorily stable throughout the procedure.
- The combined sciatic and 3-in-1 block facilitated successful lower limb amputation in a high-risk patient.
Implications:
- This case highlights the safety and efficacy of combined sciatic and 3-in-1 nerve blocks for lower limb surgery in hemodynamically unstable patients.
- Ultrasonographic guidance enhances the precision and safety of these regional anesthesia techniques.